Click the icon below to download our referral form. After you download and complete the form please email the completed form to
firstname.lastname@example.org and print a copy for the patient to bring with them when they visit our office. We look forward to providing excellent care for your patient. Thank you for entrusting them to us.
Ongoing education and training is a top priority for our practice. We do all that we can to participate in local educational events and we also arrange them for the local dentistry community. For our referring offices we provide Lunch-N-Learns for the doctors and their team. During these Lunch-N-Learn events Dr. Arauz will come to your practice for a presentation and lunch is on us!
Below you will find a survey that will help gauge the interest of your team and give you an idea of topics Dr. Arauz presents at the Lunch-N-Learn events. Each team member can visit this page on our website and fill out the form. The url for the page you're currently viewing is www.implantperiohealth.com/referring-doctors.html.
You can also download the form by clicking the icon below. Once the form is downloaded you can distribute the surveys for your team. After that, collect the completed survey's and fax or email to email@example.com. For more information or to schedule a Lunch-N-Learn please email, firstname.lastname@example.org.
Lunch-N-Learn CCDHA Registration Form
In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.