Refer a Friend or Patient

Thank You for Your Referrals

Thank you for considering Dr. Lisa James as a partner in your patient’s dental treatment. Dr. James would be pleased to coordinate with you to help your patient achieve a healthy, beautiful and functional smile.

We treat every patient as an individual with a unique set of treatment needs. Listening well and understanding your patient’s objectives is the foundation of our practice. Being resourceful in dealing with unique dental conditions and responding creatively is our art. We welcome and appreciate your professional input and your perspective on any problems or needs unique to your patient.

Please be assured that when you refer a patient to our care, you will not be left in the dark. Any special care instructions on the post-reconstruction care of your patient will be relayed to you. We truly value your referral and the patients who visit us for their specialized care.

*Updated* Click here to download printable referral (.pdf).

    Your Name (required)

    Your Email (required)

    Name of the Patient You Are Referring (required)

    Patient's Phone Number (required)

    Patient's Email (required)

    Relationship to New Patient

    DentistDoctorOther Medical PracticionerFriendSiblingParentSpouse/PartnerSon/DaughterOther

    Dental Concerns (required)