Findlay Periodontist Office | Periodontics Findlay
About
Periodontal Disease
What is a Periodontist?
When to See a Periodontist
Periodontal Hygiene
What is Periodontal (Gum) Disease?
Types of Periodontal Disease
Signs and Symptoms of Periodontal Disease
Causes of Periodontal Disease
Mouth – Body Connection
Periodontal Disease and Diabetes
Periodontal Disease, Heart Disease and Stroke
Periodontal Disease and Osteoporosis
Periodontal Disease and Pregnancy
Periodontal Disease and Respiratory Disease
Diagnosis
Treatment
Maintenance
Dental Procedures
Dental Implants
About Dental Implants
Dental Implant Technologies
Implant Rescue
Dental Implant Procedures
Single Tooth Replacement
Multiple Teeth Replacement
Full Arch Replacement
Periodontics
Cosmetic Periodontal Procedures
Periodontal Health
Gum Disease
Periodontitis Treatment
Gum Disease FAQ
Periodontal & Cosmetic
Bone Grafting
Crown Lengthening
Gum Grafting
Gum Recession
Gum and Jawbone Corrective Treatments
Sinus Augmentation
Non Surgical Periodontal Treatment
Bruxism
Oral Cancer Exam
Periodontal Scaling and Root Planing
Pocket Irrigation
Prophylaxis (Teeth Cleaning)
Antibiotic Treatment
Pocket Reduction Surgery
Regenerative Procedures
Ridge Modification
Root Amputation
Soft Tissue Grafting
Botox
Teeth in a Day
Patient Info
New Patients
Pre-Operative Phase
Post-Operative Aftercare
Patient Resources
Referrals
Periodontal Referral
Photos
Contact Us
Toledo Periodontal Office
Findlay Periodontal Office
Maumee Periodontal Office
Periodontal Referral Form
Website
Patient Information
Patient Name:
*
Gender:
*
Male
Female
Date of Birth:
*
Patient’s Home Number:
Patient’s Work Number:
Patient’s Cell Number:
Specify Tooth/Teeth:
Reason for Referral:
Consultation for possible periodontal treatment
Consultation for a previously treated tooth
Consultation for dental implants
Other
Notes:
Post space required:
Yes
No
Referring Dentist
Referring Office:
*
Referring Dentist:
*
Date:
Email:
*
Phone:
*
Extension:
Diagnostic films:
Are needed
Patient will bring
Have been mailed
Attached
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