Online Referral Form

Dear Memorial Oral and Maxillofacial Surgery Family and Friends,

As we all know, COVID-19 is having a dramatic impact on our lives and families.  Our doctors and staff are working to continue to treat your patients and will continue to do so unless we are otherwise notified.  We want to share an update with you on what Memorial Oral and Maxillofacial Surgery is doing to keep our patients and staff members safe while we continue to operate during this pandemic. 

We are following the guidance of global health experts at the World Health Organization (WHO), the U.S. Centers for Disease Control (CDC), and the American Dental Association (ADA) on preventing the spread of the COVID-19 virus. We are having all patients who enter our office answer a medical questionnaire before we begin treatment. We are also reminding our employees about frequent hand washing, and we are increasing the frequency of cleaning and disinfecting our offices. Importantly, we are asking that all of our staff members stay home from work if they feel sick or have sick family members.

Thank you for your understanding and patience during this time, and for the confidence you have shown in Memorial Oral and Maxillofacial Surgery to allow us to treat your patients.

Stay Safe!

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 Submit 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.