REFERRING DOCTORS: Online Referral Form

The doctors at Costa Mesa Oral Surgery aim to provide optimal quality surgical care with dependable reliability and compassion. We consider it a privilege to care for your patients. We strive to treat both patients and referring doctors with dignity. We understand many patients may have other treatment needs in your office, thus we are willing to discuss treatment plans with you to provide the most cost-effective and efficient treatment plan for your patient. We view ourselves as an extension of your office.

Please fill out the online referral form or use the printable PDF form to email or fax to our office. Additionally, please provide your patient a copy to bring to their consultation. Thank you.

Fax: 949-688-1993

Email: [email protected]

Online Referral Form

Printable/PDF Referral Form

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Contact us with any questions or to schedule an appointment!

Call us: 949-688-1991