Appointment Request

Our practice is a specialty periodontal and implant surgery practice and our patients are recommended to us primarily from referrals through our general dentist colleagues. However, we do accept patients that seek our consultation without the direct referral from a general dentist. We collaborate with outstanding restorative dentists, prosthodontists, other dental specialists, and our medical colleagues in a TEAM APPROACH to patient care.

To us, the greatest compliment is the referral of friends, family, acquaintances, or anyone that requires specialty periodontal and dental implant surgical services. WE ARE ACCEPTING NEW PATIENTS.

The referral sheet below has been provided for download to enable you to highlight the specific concerns or problems that have been identified by the referral source so that Periodontal Medicine and Surgical Specialists, LTD can attend to the “chief complaint”. We always, however, address any patient with a comprehensive approach to the examination process so that no problem is left unaddressed.

Fields marked with a * are required










Please evaluate the following condition/treatment:


Please remove marked teeth or mark desired implant positions