Lakes Oral Surgery Online Patient Referral Form

At Lakes Oral Surgery, we value our relationships with referring dental practices and are proud to partner with you in providing excellent oral healthcare to our community.

You may refer patients to our office by filling out our secure online Referral Form. The security and privacy of patient data is one of our primary concerns and we have taken every precaution to protect it.

To achieve a high level of trust with our shared patients, we:

  • Review cases thoroughly in advance
  • Refer back to your office for restorations
  • Collaborate with you on treatment plans
  • Are available in an advisory role if requested
  • Offer accommodating scheduling
  • Provide timely assessments and imaging

We have a selection of tools and resources assembled here such as our referral form and links to articles you may find interesting. If you have any questions about our practice, please call us at West Bloomfield Office Phone Number 248-669-6600.

Above all, we want to thank you for your referral of our office.

Technical Note:

Our online form uses the latest version of Adobe Acrobat Reader to conveniently submit the form from home or work. Please download the free plug-in from Adobes web site if it is not already installed on your system. It is important that you have at least version 9 of the plug-in to successfully use our online form.

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