Provider Referral Forms

Thank You For Choosing Health Centered Dentistry as a Trusted Extension of Your Patient Care

We’ve made it easy for you to refer patients for treatment. Browse the forms below, download what you need, and submit it when ready. Our team is here to support both you and your patients every step of the way.

General Patient Referral Form

Use this form to connect your patients with Health Centered Dentistry for comprehensive care. By sharing relevant clinical details and patient information, you help us deliver a seamless, high-quality experience. Our team will coordinate next steps and ensure your patient is well cared for.

Download the General Referral Form

Sleep Apnea Referral

Submit this form to refer a patient for sleep apnea evaluation and treatment. Include relevant health information and any prior testing. We will contact the patient directly to schedule their consultation.

Download the Sleep Apnea Referral Form

“Dr Henrie and Dr Marchant at Health Centered Dentistry have been taking care of my family for years. They are wonderful dentists! Everyone in the office is kind and friendly and even my kids love to go. I recommend them highly.”

Shelby Burger

Thank You For Choosing Health Centered Dentistry as a Trusted Extension of Your Patient Care

General Patient Referral Form

Sleep Apnea Referral

Contact Us

Office Hours

Provider Referral Forms

Thank You For Choosing Health Centered Dentistry as a Trusted Extension of Your Patient Care

General Patient Referral Form

Sleep Apnea Referral

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Contact Us

Office Hours