For Referring Doctors

Thank you for entrusting us with the care of your patient!

Smiling doctors referring their patients to our oral surgeon

Download Our Referral Form

We take great pride in ensuring your patient’s experience is consistent with the expertise and compassionate care you extend to them.

Download a copy of our referral form and email to team@surgerycenteraz.com, or fax to (480) 279-0784. X-rays can be emailed to team@surgerycenteraz.com

Oral Surgery Referral Form

CT Imaging

CT Imaging Services, including Conebeam imaging, means computerized tomographic imaging with no contrast, which is limited to the head and neck. Services include CT Imaging, a consultative report by an Oral and Maxillofacial Radiologist or Medical Radiologist, and mailing the images to the referring doctor.

To refer your patient for a CT scan download a copy of our CT referral form.

CT Referral Form