Referring Physicians

Thank you for choosing Children & Teen Dental. We are committed to providing excellent service and care to you and your patients. We are fortunate to maintain strong relationships with other physicians in our area, and our mutual referral process is instrumental in connecting us with patients in need.

Referring Physician Liaison

Our liaison is available to answer your questions about appointment scheduling, our physicians and services, education seminars, or other concerns. She can also schedule a meeting to introduce our physicians to your staff.

Contact our Referring Physician Liaison at 770-744-4581

Thank you for trusting your patient’s care to us.
Children & Teen Dental


Referring Physician Referral Form

Please complete the form below to refer a patient to Children & Teen Dental. We will contact the patient and schedule the appointment.





Referring Physician Information


Patient Information


Referral Information


1-2 days1-2 weekswithin a monthnext available

ConsultationDiagnosisOrthodontics

We are providing this Contact Us form as a convenience but your message to us should not imply the creation of a doctor-patient relationship (which only happens when you come to our office for a visit). We therefore ask that you not include personal health information in your message. Please call us if you’d like to send us personal information so that we can make sure it’s handled securely.

Schedule an Appointment for Your Child


We are providing this Contact Us form as a convenience but your message to us should not imply the creation of a doctor-patient relationship (which only happens when you come to our office for a visit). We therefore ask that you not include personal health information in your message. Please call us if you’d like to send us personal information so that we can make sure it’s handled securely.