Thank you for your interest in Commonwealth Oral & Facial Surgery. Our Doctors are committed to providing the highest standard of professional care for your patients. We appreciate and value the trust you have placed in us and we hope to create a lasting and mutually beneficial relationship.

Online Referral Form & Submitting Digital X-rays and Photos

You may refer patients to our office by filling out our secure online Referral Form below. You may also attach digital x-rays or photos once you have submitted the form.

Online Referral Form Printable Referral Form (PDF)

After you have completed the form, please make sure to press the Submit button 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.

If you would prefer to e-mail x-rays, photos or a referral, please contact us at referrals@commonwealthofs.com.

Online Patient Registration

You may preregister with our office by filling out our secure online Patient Registration Form. After you have completed the form, please make sure to press the Submit button at the bottom to automatically send us your information. On your first visit to our office, we will have your completed form available for your signature. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

Online Registration Form Office Schedule (PDF)