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.

Link to printable Referral Form for endodontic treatment. Steven G. Starr, DDS has over 20 years experience in endodontics -- root canal treatment, root canal retreatment and root canal surgery. We look forward to serving you and your patients.

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

Technical 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.