Referring a Patient for Evaluation and/or Treatment
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.
Until the new system is on-line, radiographs can continue to be sent up through our HIPAA compliant portal sponsored by eDossea using the link below.
- Click here to send x-rays to Anchor Bay Oral Surgery, PC
- This is a HIPPA Compliant Portal
Are you Referring your patient for Cone Beam CT Scan ONLY
We have also provided a PDF version of the CBCT prescription that you can print, complete and give to the patient at the link below.
CLICK HERE for the CBCT ONLY Rx Form – This is a fillable PDF. Once completed, it will need to be printed and signed as a prescription. Please note, the images will be sent for a formal OMFR unless you indicate that DO NOT want to have the images read!
We have added Dental Cone Beam Scanning technology at Anchor Bay Oral Surgery, PC. We are not providing services as a formal imaging center, but on the occasion where you feel your patient may benefit from a 3-dimensional dental x-ray we can assist in securing the view you desire, you can request a limited, view, full arch and Airway evaluation CBCT, by providing a prescription to your patient.
We will be unable to fulfill the request for taking a CBCT, without a signed prescription form. We have printed hard copy Prescription forms we can provide for your office. Please let the office know if you are in need of a supply.
We have also provided a PDF version of the CBCT prescription that you can print, complete and give to the patient at the link below. The link below provides a PDF that you can fill out on line, print and sign and send back to us at [email protected] or fax to 586-725-2400