Dr. Scott Clayhold
JawMouthFace Surgical Excellence 425.369.1533
Online Referral Form
Online Referral Pad
If you wish not use a paper referral pad, we have provided a digital copy. Please complete the online pdf referral pad and either email or fax it to our office. Thank you.
referral pad - Online.pdf
Adobe Acrobat document [743.8 KB]
If you wish not use a paper referral pad, we have provided a digital copy. Please complete the online pdf referral pad and either email or fax it to our office. Thank you.
referral pad - Online.pdf
Adobe Acrobat document [743.8 KB]
X-Rays
If you have PAs or a Pano that are within 12 months, please send a copy in the mail or a digital version to our email. Our system can accept jpg and pdf formats for digital copies.
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