Many of our clinics require a referral from your outside provider. The forms can be sent via secure email, FAXED, or mailed to the address listed on each form. Please consult our referral email policy before sending any patient information via regular email. The referral form will indicate if you need to include readiographic images.
The Center for Pediatric Dentistry»
Pediatric Dentistry Referral Form (PDF)
FAX: 206-543-0063 | 206-543-5800
DECOD Clinic »
Visit the DECOD Clinic pages for referral information.
FAX: 206-221-5276 | 206-543-4619
UW Dentistry Faculty Practice»
Faculty Practice Referral Form (PDF)
FAX: 206-616-8545 | 206-685-8258
Endodontics Clinic»
Endodontic Referral Form (PDF)
FAX: 206-616-9786 | 206-543-3995 | referral@uw.edu
Northwest Center for Oral and Facial Surgery »
NWCOFS Referral Form (PDF)
FAX: 206-616-7251 | 206-543-5860
Oral Radiology Service»
Please visit the Oral Radiology Services page as there are several options for radiographic images.
Oral Surgery Clinic »
Oral Surgery Student Clinic Referral Form (PDF)
FAX: 206-616-7251 |206-685-3591
Graduate Prosthodontics Clinic»
Please FAX a referral and cover letter to the clinic.
FAX: 206-543-7783 | 206-685-7522