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Referring Doctors

We are honored to receive the referrals of our healthcare colleagues. Please use our online referral form or download/print the PDF version to send us a brief background of your patient.

Submit a referral online, or download/print our form:

Referral Form Submit Online »

Referral Form Download PDF »


We will send you a comprehensive report following your patient's evaluation. We invite you to Contact Dr. Bennett and the Hartley Bridge TMJ & Dental Sleep Center Team for information or assistance.

Thank you for your kind referral!