Information for Referring Doctors
The following forms can be used for a variety of referral needs. If you require assistance with these forms, please contact our webmaster.
Services requiring a referral
Endodontics (Root canals)
Oral and Maxillofacial Pathology Services
Oral and Maxillofacial Surgery
Periodontics (Gum disease)
- Referral form
- Please email radiographs and the Graduate Periodontal Referral Form to [email protected].
Prosthodontics (Crowns, bridges, dentures and implants)
Radiology (X-ray services)
- Cone Beam CT Order Form
- Conventional Image Order Form
- Oral and Maxillofacial Radiology Interpretation Service
Ohio State Dental Faculty Practice
Upper Arlington Dentistry (off-campus clinic)
The following services do not require a referral:
General Practice Residency (General Dentistry)
- Call 614-292-2622
Orthodontics (Braces, bite correction)
- Call 614-292-9100
Pediatric Dentistry
- Call 614-292-2027