Doctor Referral Form (for doctor's office use only)
You may refer patients to our Rochester, NY, Prosthodontics office by either filling out our online form below or downloading and printing our Referral Form. If you opt to download and print our form, after you have completed the form, please fax it to 585-248-8643 to send us your information.
Referral to Brodine Prosthodontics
Or, download the form below, fill it out and fax it to 585-248-8643 to send us your information.
If you have any questions, please call our office.
Office Hours
Monday through Thursday: 8:00 AM - 4:00 PM
At Brodine Prosthodontics, we value our relationships with referring dental practices and are proud to partner with you in providing excellent oral healthcare to our community.
In order to optimize care for our shared patients, we:
- Review cases thoroughly in advance
- Refer back to your office for restorations
- Collaborate with you on treatment plans
- Are available in an advisory role if requested
- Offer accommodating scheduling
- Provide timely assessments and imaging
If you have any questions about our practice, please feel free to call us.
Above all, we want to thank you for your referral of our office.
Technical Note
These forms are in PDF format. If you do not have Adobe Reader installed on your computer, you may download Acrobat Reader for free and use it to access the forms.
