Thank you for your generous referral! CBCT scans. Please complete our secure online referral form below. Please enable JavaScript in your browser to complete this form.Referring Doctor *Referring Doctor Email: *Patient Name *Patient Phone Number *Patient Email Address *Reason For ReferralTooth Number(s)Upload your Xray: Click or drag a file to this area to upload. X-Rays can also be emailed to: info@endodonticgroup.comNameSubmit Printable referral form can be downloaded and given to your patient Download Referral Form Your trust is greatly appreciated. A report including radiographs (and photographs, if any) will be forwarded to you once we have examined and/or treated your patient.