For Referring Doctors

A straightforward path for your patients.

We work closely with referring dentists and physicians throughout treatment, and we keep you informed every step of the way. Use the form below to send a referral, or print a copy to keep on hand at your office.

Send a Referral appointments@edistooralsurgery.com
Fax (803) 531-3668

Questions? Call our office at (803) 534-5444

We Treat Wisdom teeth, implants, pathology, trauma, TMD, orthognathic & full arch cases

Patient Referral Form

View, download, or print

The form below is the same referral pad used in our office. You can fill it out by hand after printing, or download it to keep a stack at your front desk.

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