Refer a patient to us by downloading our Referral Form and sending to our office.

Download Referral Form PDF from the list below:

↓ Referral Form for Crystal Lake Oral Surgery

↓ Referral Form for Lake Geneva Oral Surgery

↓ Referral Form for Huntley Oral Surgery

↓ Referral Form for Burlington Oral Surgery

Directions for Forms:

  1. Fill out form using your computer
  2. Save completed form to your desktop
  3. Email as an attachment to preferred office

Alternatively, download PDF, print and fill out by hand, and mail or fax to preferred office.