Below is an on-line patient referral form should you wish to complete. As an alternative you may still mail, fax or provide the patient with referral forms as they are referred to our office. We look forward to working with you to care for your patients periodontal and dental implant needs.
Online Referral Form
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 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.
Technical Note:
Our online forms use the Adobe Acrobat 5 Plugin. Please download the free plugin from Adobe's web site if it is not already installed on your system. It is important that you have version 5 of the plugin, in order to successfully use our form.
Referring Doctors
Walter E. Colón, II DMD, MS
1614 West Plaza Drive
Tallahassee, Florida 32308
tel: (850) 878-6111
fax: (850) 656-4099