For in-person consultations, please complete and print the referral form below.
Kindly email a copy of the completed referral form, along with any relevant radiographs and/or clinical photos, to info@jawimplant.com.
Prefer a physical referral pad?
Please call or email the office, we would be happy to mail one to your practice! 770-799-6028
For provider-to-provider virtual consults (DDS/DMD only), please click on the “Virtual Consult Portal” tab on the upper right.
Thank you!!
Contact:
705 Town Boulevard, Suite Q360
Brookhaven, GA 30319
Located within Atlanta Oral and Maxillofacial Surgery & Dental Implant Center
P: 770-799-6028
F: 770-462-5428
info@jawimplant.com