Online Referral Form

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 Complete and Send 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.

Online Referral Form

Why Refer Your Patients To Our Practice?

We respect the relationships you have developed with your patients and are committed to open communication and prompt follow-up after your patient is seen.

We do not judge and recognize that you are the primary care dentist for your patients.  We expect to entrust your patient back to your ongoing dental care after being treated at our office for periodontal treatment and or implant placement. Our practice is in-network provider for many insurance companies. Let us collaborate with you to provide the highest quality patient care to your patients.

Availability: Dr. Bal is always available to discuss a patient’s condition even before the referral is made to our practice.

Expertise and Quality.  Dr. Bal is a board-certified periodontist. We use the treatment methods that have been time tested for the best possible outcomes and only use Straumann and Nobel BioCare implant systems.

Collaboration and communication. We work with our referring dental partners and timely communicate with your offices regarding the care provided at our office.

Ease. Click, call or fax — we offer several ways to refer patients, all streamlined to save time for your staff and patients.