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Referrals to the Advanced Endodontics Clinic

The Advanced Endodontics Clinic accepts referrals from the Memphis community and beyond. We are a full service endodontic practice staffed with postdoctoral residents, supervised by experienced faculty clinicians.

We value our relationship with referring doctors and are committed to meeting and exceeding your professional needs by providing timely communication and efficient referral service. If interested in referring a patient for clinical evaluation and endodontic treatment, please feel free to directly contact the Advanced Endodontics Clinic:

Appointments: 901-448-1546
Fax: 901-448-1541

Endodontics Patient Referral Form

Completion of a referral form is mandatory for treatment. Once completed online you should press the “email” button which will deliver the information to our secure server. Any digital radiographs can also be emailed directly to endopg@uthsc.edu.

Remember to identify the radiograph with the referral form when emailing.

Please note we are a paperless office and would prefer all communications via email.


 

Technical Notes
Use our online PDF form to conveniently submit the form from home or work. Please download the free plug-in  from Adobe's web site, if it is not already installed on your system. It is important that you have the latest version of the plug-in to successfully use our online form.

Mac Users
Please note Apple’s Preview application and plug-in does not handle interactive forms properly. You must use the Adobe Reader application.

May 26, 2022