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If you are a doctor or referring provider, we are happy to assist your patients. Thank you for considering a referral to Prairie Oral & Facial Surgery. To streamline the process for you, we have built this page to be your one-stop-shop for referring patients to Prairie Oral & Facial Surgery.

Have any questions along the way? Please feel free to contact us directly at [email protected]. Thank you!

Referral Form

PATIENT REFERRAL FORM – PLEASE FILL OUT

Please fill out the referral form as thoroughly as you can. We will get in touch with your patient based on the information filled out on this form.

CONTACT OUR CLINIC

If you are having any difficulties accessing the online form, or would like to pass along your referral in a different format, please consider any of the following options:

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BY PHONE

Local: 701-478-4404

Toll Free: 1-866-478-4404

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BY EMAIL

[email protected]

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BY FAX

701-478-4407

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BY TEXT

701-478-4404