PATIENT REFERRAL FORM






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    LeftPrimaryRight

    Instructions For First Visit

    Relax! Our offices are no judgement zones. We will make you feel comfortable throughout your procedure.

    Please bring the following to your appointment:

    • Referral slip
    • Any x-ray your dentist has given you
    • Medication list
    • Photo ID
    • Dental insurance
    • Parent or legal guardian if you are under 18 years of age

    Please provide us with 48 hours notice if you need to change your appointment time.





    Contact Us Today

    Make an appointment, plan your visit, or get information from our knowledgeable staff using the info below.


    SCHEDULE YOUR APPOINTMENT

    Call Us Today!
    (865) 637-5708



    VISIT US

    303 S. Concord
    Suite 323
    Knoxville, TN 37919



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