Referring Doctors

Online Oral Surgery Referral Form

The Center for Oral Surgery & Dental Implants welcomes referrals from colleagues. We strive to provide an exceptional oral surgery/implant experience by supporting our patients and their referring doctors. At the appropriate stage of treatment, patients will be returned to their referring dentist.

We are available for consultation or treatment for any of the following:

  • Planning and assessment
  • Bone and soft tissue grafting
  • Impression procedures
  • Prosthetic try-in/fitting of prosthesis
  • Bone expansion procedures
  • Single tooth spaces potentially requiring implants
  • Multiple toothless spaces/complex restorative needs
  • Where one or both arches are edentulous or near edentulous
  • Full or partial dentures requiring implant stabilization
  • Difficult implant cases: for example, due to anatomical structures or insufficient bony volume
  • Aesthetic rehabilitation &and complex aesthetic cases

We invite you to speak to any of our doctors to discuss the needs of your patient. Informal inquiries are welcome.

You may refer patients to our office by filling out our secure online Referral Form. After you have completed the form, please make sure to press the Submit button at the bottom to automatically send us your information. The security and privacy of patient data is one of our primary concerns and we have taken every precaution to protect it.

Online referral form

Or you can downloading our referral form and fax it to 616-361-9882.

You can email any necessary patient x-rays as an attachment to: info@palm-panek.com