Lexington Endodontics Referral Form
We are ready to receive HIPPA protected information directly from your computer; you do not need to have secure email at your office. If you do not have a user name and password simply call us and we will provide them to you, this information will allow you to login under the Multidisciplinary Doctors portal. Using this feature you can securely access the real time patient referral service available to you by our digital office software.
For a paper copy of our referral form please click on the image below and print the form. If you do not have Adobe reader, click here for a free download.