Referral Forms - For Providers

We welcome referrals from other dental and medical providers. To send a patient to our office, please:
  -Download the appropriate form below
  -Fill out and fax to 406-586-5881
  -If you prefer, you may email us the information to info@refreshingdentistry.com
Thank you for your referrals!

Referral Forms

Printable Patient Info

General Referral Form (Medically Complex or Healthy Patients)

Adult IV Sedation / General Anesthesia Referral

Pediatric General Anesthesia Referral

Radiation Oncology Referral



Questions?

Please don't hesitate to contact the Mint* office at 586-5880 with any questions or concerns regarding the information provided on this page.