Referral Form

To refer a patient to our office, simply download our Referral Form by clicking the link below, print it out, and complete all the required information. You can then fax the form to our office at 770-520-8452 or have your patient bring it with them to their scheduled appointment.

If you have any questions, contact our office at  770-520-8454 or via email at info@padhiarperiodontics.com

Scroll to Top