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Please Evaluate
 Periodontal Condition Osseointegrated Implant Therapy Crown Lengthening Cosmetic Gingival Recontouring Biopsy Tissue Grafting Recession Periapical Abscess Frenulectomy and Fiberotomy Periodontal Maintenance Care Impacted Tooth Exposure Endodontic/Periapical Surgery Laser Periodontal Therapy

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 PLEASE CONTACT PATIENT TO SCHEDULE AN EXAMINATION APPOINTMENT.

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*If unable to honor appointment please give courtesy of 48 hours notice: (770) 740-0442
If you have dental insurance, be sure to bring your insurance card with you.

PLEASE PROVIDE THE FOLLOWING PERIODONTAL REFERRAL INFORMATION

Radiographs taken in the last 3 years  PAN FMX PA BW
Being sent with  Patient Mailed to us Emailed to us

Last Prophylaxis

Last Scale/Root Planing

Major Restorative Treatment Planned/Completed

Any Other Information