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  Doctor's Referral Form  

Oral and Maxillofacial Surgery of South Texas is dedicated to providing your patients and their families with the highest quality of oral surgery care. We look forward to the opportunity of treating your patients and appreciate the referral.

If you would like to send us a referral from this website please fill out our Referral Form and Submit Online. You may also fill out the Referral and select to print it and mail or fax it to our office. We are also able to provide your office with referral slips for your convenience.  

       Download Doctor's Referral Form
           (Please right-click the link and save to your computer.)

Technical Note:

You need Adobe Acrobat Reader to view our form. Please download Acrobat Reader from Adobe's web site if it is not already installed on your system.

Digital Signature Note:

Doctors must digitally sign the referral form. Please click Sign Here and follow the directions to setup a new digital signature.  If you have any questions, please feel free to contact support at:

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