Phone: 606-324-6494  |  Fax: 606-325-4144

Downloadable Forms

Medical History - Front Pages

Periodontal Charting

Medical History - Back Pages

Maintenance Charting

Referral Form

Sending Radiographs Electronically

If you take radiographs electronically, you can save time and expense by sending them electronically.  Simply export the radiograph to be sent as a .JPG file and email.  To protect the patient’s privacy,  only use initials or simply send the patient information in a separate email.

Sending Film Based Radiographs

We have systems in place to reliably track radiographs that we receive and make sure they are returned in a timely manner.  Film based radiographs that are received are scanned in to our office software.  We want you to be comfortable sending radiographs on patients you have kindly referred for care.