Referral Form

Southwest Endodontics is proud of the individual attention we offer patients in all aspects of conventional and surgical root canal treatment. State-of-the-art techniques, such as the surgical operating microscope and digital radiography are used on every patient to enhance treatment results.

We truly understand the importance of communication to achieve the best results for our mutual patients. We can email a final report with imaging the same day treatment is completed, or mail a hard copy report if you prefer. If you have any questions or concerns please don’t hesitate to contact at us 435.674.3636.

You can access a printable version of our referral form by clicking on the referral card below. You can email or fax this information to us, or provide a completed referral form to your patient to bring to the appointment.

Link to printable Referral Form for endodontic treatmentTechnical Note: You will need Adobe Acrobat Reader to view our form. Please download the free Acrobat Reader from Adobe's web site if it is not already installed on your system.

Southwest Endodontics, Root Canals, St. George, UT, Dentist Endodontist, Root Canal Dentist, Root Canal Pain, Endodontist, Endodontics, Board Certified