Referrals

We are honored that you will place your trust in us for your patients. To refer a patient please call us, use the link to our referral card, or use our online form below. (Note: The link is a PDF that will open in a new window.)

Download our referral card.

Referral

Doctor Name(Required)

Practice Name(Required)

Reffering Office Phone(Required)

Reffering Office Email(Required)

Referral Information

Name of the Patient You are Referring(Required)

Patient's Phone Number(Required)

Patient's Email(Required)

Radiographs Sent?

Yes

Message

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Dr. Thomas Is Always Welcoming New Patients

If you have any questions for Dr. Thomas and Restore Prosthodontics & Implant Center please let us know. We would be happy to schedule a time to meet with you.