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Dentist Referrals – Colorado Springs, CO

Helping Dentists in the
Colorado Springs Area

Rocky Mountain Periodontal Specialists look forward to working with you to restore the oral health of your patients. Our experienced and highly trained periodontists will ensure that your patients receive the specialized care they need. At our Colorado Springs periodontal office, we offer a variety of services, including:

To refer your patient to Rocky Mountain Periodontal Specialists, please begin by filling out our referral form below, or call us during business hours at (719) 574-4867. We need the following information:

Our periodontists are trusted professionals in the Colorado Springs area. We will work closely with you to ensure the complete care of your patient, and we will keep you informed every step of the way. We are honored to partner with you to create optimum periodontal healing and health for your patient.

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Rocky Mountain Periodontal Specialists welcome inquiries from referring dentists in the Colorado Springs area. If you have a patient who needs our periodontal services, please contact us today!

Referring Dentists Form

Referring to Dr.*
Introducing
Email*
Phone #
Address
City/Zip
Referred by
Date
Comprehensive Evaluation
Limited Evaluation

Please Indicate Instructions:

An appointment was made on with your periodontal office.

Yes No
Yes No

Radiographs:

Yes No
Yes No
Yes No
Yes No

Reason for Referral (Please Include Tooth Numbers and Areas):

Periodontal Therapy to date:

Significant medical, dental history which may help:

Comments/proposed restorative treatment: