Referring Doctors

Thank you for your referral to Northern Periodontics & Implant Dentistry. Your referral, including patient information and any radiographs/ images, will be instantaneously uploaded safely and securely through our HIPAA-compliant website to our scheduling coordinator. 

Please click the link below to refer a patient to our practice using our convenient online portal:

Please note that the form will not submit without all appropriate information filled out.

If the patient's email address is unavailable, please type in no@no.com and the form will still send.

If you need assistance with form submission, please contact our office.