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Refer a patient

Send a patient our way

A quick, peer-to-peer hand-off. We’ll contact your patient to schedule the fit consult, keep our scope narrow to the masticatory muscles, and send a chart note back to you. Your patient stays yours.

About you (referring provider)
About the patient

This form is for a high-level referral hand-off. It is not a secure clinical-records channel; do not include detailed protected health information. See our privacy policy.

Prefer to talk first, or want the clinical protocol and boundaries? See the provider overview, or email [email protected].