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. Please provide as much information as possible Thank you and we look forward to seeing you in our office in Augusta, GA.
For your initial consultation visit, please bring any x-rays from your referring dentist, your referral slip, your insurance information, a valid picture ID and a list of any medications you are taking.
Call us at Dr. Samuel C. D'Arco, DDS Phone Number 706-228-3100 if you have any questions about referring patients to our office.