Northwest Oral & Maxillofacial Surgery Online Patient Referral Form
At Northwest Oral & Maxillofacial Surgery, we value our relationships with referring dental practices and are proud to partner with you in providing excellent oral healthcare to our community.
You may refer patients to our office by filling out our secure online Referral Form. After you have completed the form, please make sure to press the Complete and Send button at the bottom to automatically send us your information. The security and privacy of patient data is one of our primary concerns and we have taken every precaution to protect it.
To achieve a high level of trust with our shared patients, we:
- Review cases thoroughly in advance
- Refer back to your office for restorations
- Collaborate with you on treatment plans
- Are available in an advisory role if requested
- Offer accommodating scheduling
- Provide timely assessments and imaging
We have a selection of tools and resources assembled here such as a referral form and links to articles you may find interesting. If you have any questions about our practice, please call us at Arlington Heights Phone Number 847-392-6220.
Above all, we want to thank you for your referral of our office.
- Monday-Thursday 8:00 AM to 5:00 PM
- Friday 7:30 AM to 2:00 PM
- Saturday 8:00 AM to 11:00 AM
- **Lake Zurich and Elgin are closed on Wednesday and Saturday- Calls will be directed to the Arlington Heights office on those days!
- **Business hours are subject to change