Referring Doctors

Do you have a patient with special needs who needs assistance with a dental problem? Our team at Disability Dental Services can help provide them with the treatment they need to get out of pain or preserve their smile. We welcome referring doctors to fill out the form below and submit it to our dental office. Once we provide your patient with the specialized oral care they need, we’ll put their health back in your hands.

Once we receive this information, we will contact you and exchange treatment plans, x-rays, and progress notes.

  • Required Fields

  • MM slash DD slash YYYY
  • Optional Fields

  • Referral Source

  • If you are a provider and have a general inquiry about our office before referring,
    please contact our administrator directly at or (210) 697-7377