Referring Dentist/Physician Information

Drs. Kelly and Kimberly follow the standards set by the American Academy of Dental Sleep Medicine (AADSM). Dr. Kimberly is a Diplomate with American Board of Dental Sleep Medicine. Diplomates of the American Board of Dental Sleep Medicine (ABDSM) have received the highest credential a dentist can earn in dental sleep medicine. They have demonstrated competency in dental sleep medicine by passing a rigorous written examination. 

Below are the forms to refer your patients to our office for Occlusal Appliance Therapy (OAT). Please click the appropriate from, print, and return the form to our office. Please do not hesitate to contact our office with any questions.

Physician Referral Form

Dentist Referral Form