Referral Form

Richardson Oral and Facial Surgery - Online Oral Surgery Referral Form

At Richardson Oral and Facial Surgery, we are committed to providing essential care during the COVID-19 pandemic. If you or your patients require urgent or emergent oral surgery care in the North Dallas area, please reach out to us by phone or use our secure online referral form.

How to Submit an Online Referral

You can easily refer patients to our office by filling out our secure online Referral Form. The process is quick and safe and ensures that patient information remains confidential.

Steps to Complete the Referral:

• Fill out the secure referral form with the necessary patient information.
• Once the form is completed, press the Complete and Send button at the bottom of the page.
• After submission, you will have the option to securely upload and transmit any relevant images related to the referral.

Online Referral Form

We take every precaution to ensure the security and privacy of patient data, making sure that the information remains protected.

For any questions or immediate assistance, contact our Richardson office at 972-231-6661.

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