Online Referral Form

Physicians 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 Submit 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.

Complete our Referral Form

You can also contact Dr. Akin here.

 

Technical Notes:

PC Users: Our online form uses the latest Adobe Acrobat Reader plug-in to conveniently submit the form from home or work. Please download the free plug-in from Adobe’s web site if it is not already installed on your system. It is important that you have the latest version of the plug-in to successfully use our online form.

Mac Users: You must open and submit the form in a Safari Browser with the latest Mac operating system. It is also important to have the latest version of Adobe Acrobat Reader on your computer in order to submit your form to our office correctly, please download the free plug-in from Adobe’s web site. You Must OPEN the Adobe Reader Application after installation and make Adobe Reader your DEFAULT SAFARI PLUGIN for Viewing PDF Files.


Bone Grafting

We have the ability to regenerate bone when needed. Socket preservation can repair sites with inadequate bone structure and allows more patients to become implant candidates.

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Dental Implants

Dental implants are changing the way people live. They are designed to provide a foundation for replacement teeth which look, feel and function like natural teeth.

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Wisdom Teeth

Wisdom teeth are the last teeth to erupt within the mouth. When they align properly and gum tissue is healthy, wisdom teeth do not have to be removed.

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