Refer a Patient Online
Referring a patient to Nashville Periodontal Group is simple and secure. Our online referral form is designed for dentists and their staff to easily submit all the necessary information for a seamless transfer of care.
Simply complete the required fields in the form below and click "Submit." Once we receive the referral, our team will promptly contact the patient to schedule their appointment. You can also securely upload relevant documents, such as X-rays and patient history, to ensure we have everything needed to provide the highest level of care.
These online referral tools are for the use of dentists or their staff to securely and electronically refer patients to Nashville Periodontal Group. Once submitted and received, a member of NPG’s staff will contact the patient directly to schedule an appointment. You can select the first available appointment available option or select a specific doctor depending on your preference and patient needs.
Please fill in the applicable information below and hit the “Submit” icon. Basic patient and referring doctor’s information is required. Additionally, the referring dentist can electronically upload patient documents (x-rays, applicable dental and periodontal history, scan or take a picture of patient’s insurance cards, etc.) to ensure proper delivery to Nashville Periodontal Group. Upon submission, you will receive a completed copy of your referral to retain in your patient’s chart.
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Once submitted, your office will receive a copy of this completed referral to maintain your patient records.