Thank you for entrusting your patient with specialty care needs with our practice. To help make the transfer process as smooth and convenient as possible, we ask that you download and fill out the referral forms contained on this page. If you have any other concerns we invite you to contact our oral surgeons at sahar@glendalesurgical.com. Our Pacific Coast Oral & Maxillofacial Surgery team looks forward to a great partnership!

Patient Referral Form