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Centennial, CO
8223 S. Quebec St. Ste. O
Centennial, CO 80112
(720) 277-5930
Lakewood, CO
7475 W. Colfax Ave. Ste. 103
Lakewood, CO 80214
(720) 512-2879
Aurora, CO
10401 E. Colfax Ave. Ste 150
Aurora, CO 80010
(720) 285-7972
Thornton, CO
9652 N. Washington St.
Thornton, CO 80229
(720) 453-3277
Home
About Us
Dr. Colton Flake
Dr. Greg Gardner
Dr. Nathan Green
Dr. Joe Jackson
In the Community
Our Services
Preventive
Sedation
Emergencies
Restorative
Reveal® Clear Aligners
New Patients
Insurance & Financing
Special Offers
Referral Form
Testimonials
Referral
Contact Us
Home
About Us
Dr. Colton Flake
Dr. Greg Gardner
Dr. Nathan Green
Dr. Joe Jackson
In the Community
Our Services
Preventive
Sedation
Emergencies
Restorative
Reveal® Clear Aligners
New Patients
Insurance & Financing
Special Offers
Referral Form
Testimonials
Referral
Contact Us
Home
About Us
Dr. Colton Flake
Dr. Greg Gardner
Dr. Nathan Green
Dr. Joe Jackson
In the Community
Our Services
Preventive
Sedation
Emergencies
Restorative
Reveal® Clear Aligners
New Patients
Insurance & Financing
Special Offers
Referral Form
Testimonials
Referral
Contact Us
Book An Appointment
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Referral Form
Comfort Dental Kids, Aurora, CO
New Patients in Aurora, CO
Referral Form
Introducing:*
Date of Birth:*
Parent/Guardian:
Patient Number:*
Referring Office:
Referring Email:
for a copy of this form, please enter your information
Referral Date:
Return of Patient*
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As a patient of record, return to my office
Referred For:
Emergency Evaluation Pain/Swelling
Implant/Pre-Protectic Evaluation
Frenectomy/Apicoectomy
Restorative
Endontic Therapy
Extractions
Other
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K
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32
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Radiograph:
Sent with patient
Mailed
Emailed to
[email protected]
Needs to be taken
Notes or Comments:
Centennial, CO:
(720) 277-5930
8223 S. Quebec St. Ste. O
Centennial, CO 80112
Lakewood, CO:
(720) 512-2879
7475 W. Colfax Ave. Ste. 103
Lakewood, CO 80214
Aurora, CO:
(720) 285-7972
10401 E. Colfax Ave. Ste 150
Aurora, CO 80010
Thornton, CO:
(720) 453-3277
9652 N. Washington St.
Thornton, CO 80229
Contact Our Aurora Office
New Patient?
Yes
No
Our Hours
Monday
8:00am - 5:00pm
Tuesday
9:00am - 6:00pm
Wednesday
9:00am - 6:00pm
Thursday
9:00am - 6:00pm
Friday
8:00am - 5:00pm
Saturday
8:00am - 1:00pm
Refer a patient to our office.