Please provide a completed referral slip to the patient and if possible email a copy to our office as soon as possible along with any necessary x-rays! We love PA’s but will take anything we can get. If you can include any dental insurance and an email that would be Fantastic!

We will do our best to help your patient in a kind and compassionate manner. We can provide treatment estimates prior to scheduling and will process any insurance we can.

We are currently In-Network with Delta Dental (Premier and PPO / EPO).

We are out-of-network with all other insurance companies.
We are happy to submit claims to any insurance that we can!

We offer Cherry and CareCredit for patients who need payment options.

NEW! We now have a Secure Online Referral Form
You can enter the information, upload x-rays and track status from your own dashboard. When submitted we get an email notification.

Click here> Secure Online Referral Form

A note about Sindi (the online referral platform)

With Sindi you create a free log in and you can send your referral, upload x-rays, track and message!

Sindi now allows CBCT upload along with x-rays, etc. If you do upload a CBCT please ZIP the file before uploading. There is a 500MB max file size.  We cannot guarantee that we can use the CBCT – please make sure your patient is aware. We require a Limited View CBCT – the tooth referred and surrounding only. This allows the detail we require for diagnosis. Not all systems can read other CBCT files.

 

Need more referral pads? Just give us a call and we will get some to you!

Until then Click here –>[ Foothill Endo Referral Slip – Blank PDF ].