If you are a referring doctor, please contact Mountain Perio or fill out the forms included here. We understand the great trust that goes into referring your patients, and we are grateful for your confidence in us. Our periodontists and team work hard to make sure that every patient receives the personalized, thorough and efficient care they deserve. If you have any questions about referring one of your patients to Mountain Perio, we welcome you to contact us today. We will collaborate with you to ensure that your patients get the excellent periodontal care they deserve.

Online Referral Form

You may refer patients to our office by filling out our secure online Referral Form. After you have completed the form, please make sure to press the Complete and Send button at the bottom to automatically send us your information. The security and privacy of patient data is one of our primary concerns and we have taken every precaution to protect it.