Online Referral Form

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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.

When submitting the form, you will have the opportunity to securely upload and transmit images of patient x-rays.

Online Referral Form

The security and privacy of patient data is one of our primary concerns and we have taken every precaution to protect it.

Please call our office for assistance: 919-293-0299.

Contact POMS Facial Surgery


The first step towards a beautiful, healthy smile is to schedule an appointment. Our scheduling coordinator will contact you to confirm your appointment. If you are an existing patient, this contact form should not be used to communicate private health information.

Our Locations

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Raleigh

Hours

Mon:
Tue:
Wed:
Thu:
Fri:

9am - 5pm
9am - 5pm
9am - 5pm
9am - 5pm
8am - 1pm

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Elizabeth City

Hours

Mon:
Tue:
Wed:
Thu:
Fri:

9am - 5pm
9am - 5pm
9am - 5pm
9am - 5pm
8am - 1pm