Referral Slip
File Exchange in Real Time
  Every hour long patient consultation is followed by

• the same day periodontal report
• including all x-rays*
• listing all treatment options with
• timing and other recommendations

for your review and comment.

Based on restorative plans, periodontal needs and personal preferences, Dr. Kiurtsidis works closely and coordinates treatment with all the involved parties.

* X-rays are scanned into our digital database and returned to your office immediately for your diagnostic and treatment needs.

To discuss our mutual patients' needs, latest treatment methods or preferences, please stop by or contact Dr. Kiurtsidis any time.
 

Please download*,
fill out,
and print
PDF form (2 min)



*Free Adobe Reader and printer required

Or, fill out and submit online referral (under construction).

Request new referral slips in mail.

When time and esthetics matter, we can set up secure online file sharing of images (x-rays, before and after pictures, reports etc) with your office.


For more info on this instant secure communication, please contact us directly.



Delta Dental Insurance


Dr. Kiurtsidis is a Delta Dental Premier periodontist and therefore Delta Dental DPO patients are also covered at the superior Delta Premier level.


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