Refer a Patient: Student Clinic

dds1.jpg

To refer a patient to the College of Dentistry's student clinics, use the below form.

STEP 1: Download and complete the Patient Information Form. Save the completed form where you can easily access it, like on your desktop. Upload the completed form and images/radiographs below.

STEP 2: Submit the completed Patient Information Form below. In the Description Box, put the Patient's Name.

STEP 3: Submit images and radiographs below. In the Description Box, put the Patient's Name.