For dental professionals

Secure patient referral

Send the patient's details, your clinical notes, and imaging through an encrypted form. No email attachments, no faxing radiographs.

No account or sign-in needed. Submissions travel over an encrypted connection and land directly in our practice-owned intake queue. Attachments are stored in our HIPAA-covered file storage and are visible only to authorized team members.

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Your practice

Referring doctor *

Practice name *

Practice phone *

Practice email *

Practice fax (optional)

Referral coordinator (optional)

Preferred communication method

How should we send your report?

Patient

First name *

Last name *

Date of birth

Primary phone *

Secondary phone (optional)

Email (optional)

Urgency

Clinical detail

Reason for referral *

Requested evaluation or treatment

Area / quadrant

Tooth numbers

Treatment preference

Please keep these fields to a brief clinical summary. Full chart notes, medical history, and imaging should be attached as files below — every upload is encrypted and stored in our practice-owned file storage.

Relevant clinical notes (optional)

Other special instructions (optional)

Contact our practice before seeing the patientContact our practice after seeing the patient

Records

Radiographs, clinical photographs, and PDFs. Up to 10 files, 15 MB each.

I'm authorized by my practice to share this patient's information with Transcend for the purpose of treatment.

Or call 918-288-0818