Online Referral Form

Refer a patient to Dentcare Now.

Dentcare Now is open during the week (including evenings, weekends, and some holidays) to manage your patients’ emergency needs. We focus on emergency dental services and offer appointments now. From the latest equipment to comfortable dentistry your clients can trust and afford. Remember Dentcare Now the next time you need to refer a patient due to: weekends, holidays, vacations, personal time, CE course, treatment complexity, not a patient of record, or the staff or dentist is unavailable.

Please do not send personal health information through the form, specific patient care-related questions must be addressed with your doctor during an appointment.
  • Practice Information

  • Patient Information