Referral To Periodontist For Implant Consultation

Dr. Name
Office address
City, State ZIP
(or preferably print on letterhead)

Dr. Perio
Address
City, State  Zip

Dear Dr. Perio:

I have referred [patient] to you for #12 implant consultation.  Periapical & bitewing x-rays enclosed.

Jane is a new patient to us today.  She presented with #12 crown off, with the 2-post build-up and most of tooth still in the crown.

I recemented it with C&B Metabond.  It had a loose fit, and will not last long.  She said her previous dentist recemented it in August.

She is scheduled with us in November for complete exam/treatment plan/cleaning.  Sounds like she has been regular with 6-month recalls; brief visual exam revealed no other urgent problems.

Sincerely,

 

Dr. ______