Please complete the form below to electronically refer a new patient. Please note, when referring a patient to our offices, we need a copy of the patient’s Diagnostic Sleep Study with their prescription.
Submit Patient ReferralAlready referred a patient, but didn’t have their sleep study, submit it now.
Submit Sleep StudyIf you prefer to fill out the paper version, you may download and fax the completed form to the S&G Family Dentistry office in Leawood @ fax: 913-600-5575.
Download Referral PDF