Refer a patient

Online referral

Send a referral

Prefer to talk? Call us at 770-478-6878 or email office@rootga.com.

Referring doctor

Practice name

Practice phone

Practice email

Patient name

Patient phone

Tooth number(s)

Urgency RoutineUrgent, patient in pain

Reason for referral Root Canal Treatment Root Canal Retreatment Apicoectomy / Endodontic Surgery Cracked Tooth evaluation Evaluation / diagnosis only

Clinical notes

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Why doctors refer to us

A partner for your endodontic cases

• Surgical operating microscope on every case, with rotary instrumentation
• Low-dose J. Morita CBCT 3-D imaging for accurate diagnosis
• EdgePRO laser-assisted disinfection for complex anatomy
• Consultation-only or consultation with same-day treatment
• Same-day slots for patients in severe pain whenever possible
• Temporary filling placed and clear guidance on restoration timing back to your office