Online Referral Form

Monday:   8:00 AM - 5:00 PM
Tuesday:   8:00 AM - 5:00 PM
Wednesday:   8:00 AM - 5:00 PM
Thursday:   8:00 AM - 5:00 PM
Friday:   8:00 AM - 2:00 PM

You may refer patients to our office by filling out our secure online Referral Form. After you have completed the form, please make sure to press the Complete and Send button at the bottom to automatically send us your information. The security and privacy of patient data is one of our primary concerns and we have taken every precaution to protect it.

Online Referral Form

If you have any questions about referring a patient to either Dr. Grant or Dr. Do, please call Center for Oral Reconstruction & Education Phone Number 714-771-7677 and we’d be happy to assist in any way.