For Referring Doctors

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 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

Referring Doctors Appreciation

At Wagner Oral Surgery & Dental Implant Specialists, we value our relationships with referring dental practices and are proud to partner with you in providing excellent oral healthcare to our community.

To achieve a high level of trust with our shared patients, we:

  • Review cases thoroughly in advance
  • Reinforce your relationship with the patient
  • Collaborate with you on treatment plans
  • Are available in an advisory role if requested
  • Offer accommodating scheduling
  • Provide timely assessments and imaging

We have a selection of tools and resources assembled here such as a referral form and links to articles you may find interesting. If you have any questions about our practice, please feel free to call us at Racine Office Phone Number 262-634-4646.

Above all, we want to thank you for your referral of our office.


Contact Our Office Today...

Call us with any questions or to make an appointment...
 Racine 262-634-4646  Kenosha 262-654-4222