Online Patient Referrals.

Referral Book Greene EndoWe have several convenient methods for referring doctors to refer a patient to our office; such as, filling out the form below, fax, email, or simply by calling our office.  We have someone on call to answer the phones after hours. We also have printed referral books that we can send to you. The referral books have multiple copies, keep one for your office and give the other to your patient. The back of the form has easy directions to our office. To request a printed referral book, please call or contact us at: referrals@endodoctorgreene.com

One of our staff members will promptly contact your patient to schedule an appointment. Greene Endodontics is open Monday through Friday 8 am until 5 pm. We do not see patients on Friday. A staff member is available on Friday to schedule and answer questions; however, Dr. Greene does not see patients on Fridays. We will schedule appointments as promptly as possible. If the patient has pain or an emergency situation, every attempt will be made to see them that day.


Four convenient ways to refer a patient to our office:

Phone: (765) 649-1277 (Contact us for a Referral Book.)
Fax: (765) 357-9121 (Fax in the Referral Book form, use your own form or click here for the PDF form.)
Email: referrals@endodoctorgreene.com
Web: www.greenereferral.com (Direct link to this page.)

For referrals, please fill out the form below.

    Referring Doctor: (required)

    Patient Name: (required)

    Patient Telephone Number: (required)

    Patient Email:

    Preferred Appointment Date:

    History of Trauma:
    YesNo

    If Yes, Date(s) of Trauma:

    Tooth Number(s):

    Medications Prescribed & Remarks:

    Please Select all that Apply:

    [recaptcha]

    Additional Information on Patient Referrals.

    Thank you for your interest in Greene Endodontics, a dental practice dedicated exclusively to endodontic care. We are specialist members of the American Association of Endodontics and look forward to providing your patients with excellent care. We are currently contracted providers for the Anthem, Cigna, Guardian, Maverest, Aetna DMO,  Delta Dental and Dental Health Options – Health Resources. As a convenience to our patients, we are pleased to offer a CareCredit.

    To assure that your patient is  receiving the highest quality of care, please observe the following:

    1.  If the visit is for a consultation only, we will evaluate the problem and design a treatment plan to fit your patient’s needs. This may include sedation, surgery, etc.
    2. If the patient comes to our office for  a diagnosis, or emergency appointment, the root canal therapy will be started at their first visit.
    3. At the initial visit, patients under the age of eighteen (18) must be accompanied by a parent or guardian.
    4. The patient will be asked to bring a current list of medications and supply us with all pertinent medical information.
    5. If  the patient is new to our office, we have convenient online registration forms that the patient can fill out prior to coming to the appointment. By filling them out ahead of time will allow us to attend to their dental needs more quickly than completing them upon arrival. The security and privacy of all personal data is one of our primary concerns and we have taken every precaution to protect it.

    Thank you and please contact our office if you have any questions.

     
    After being referred for a root canal, I called Greene Endodontics to check on appointment availability. I was in excruciating pain and Dr. Greene worked me in that day. The staff was very friendly and Dr. Greene explained all of the steps. I would highly recommend this practice.David F.

    Questions.

    Contact us for more information. Or call: (765) 649-1277

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