Doctor Referral

Referring doctor please print referral slip and provide it to your patient. If a Current panorex is available please email it us at office@cpcgeorgia.com or provide a legible copy to your patient.

Once we have evaluated your patient you will revive a comprehensive report. Please contact us if you have any question or would prefer referral pads.

Thank you for your kind referral!

Doctor Referral Forms

Craniofacial Pain and TMJ Disorder

Rx Oral Appliance Therapy from MD

In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.

Call us today at 678-899-6076

To schedule an evaluation and find a treatment option to help relieve your pain