Online Referral Form

You may refer patients to Asrari Endodontics by filling out our secure online Referral Form. After you have completed the form, please make sure to press the Submit 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.

We take every precaution to make sure your patients are treated safely, including touch-less registration and payment, use of a disinfecting mouthwash before treatment, using a dental dam to isolate the tooth, air purifiers to scrub harmful bacteria and viruses from the air, and disinfecting the treatment rooms with ultra violet light to kill airborne organisms or inactivate microorganisms on surfaces.