Referral Form
Thank you for referring your patients to Cape & Islands Periodontics and Oral Surgery. Please use the form below to send us a referral.
Referring Doctors
We appreciate the trust you place in us when referring your patients. Our team will contact referred patients promptly and keep you informed of their care and treatment outcomes.
How to Refer
- Download and complete our referral form below
- Fax or email the completed form to your preferred office location
- Or call us directly: 508-204-3145
What to Include
- Patient name and contact information
- Reason for referral / chief complaint
- Relevant medical and dental history
- Any pertinent X-rays or records