
Referring Offices Resources
Referrals can be filled out and printed, faxed or emailed.
Email:
Fax: 605-348-1626
***We ask that referrals sent with patients have a doctor's signature on them.***
Please fill out for all SD Medicaid patients being referred for removal of 3rd molars/wisdom teeth.
Patients may print and fill out Patient Registration Forms to bring with them to the appointment, or they may complete registration forms when they arrive for their appointment.
3rd Molar Referral Form