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 Submit button at the bottom to automatically send us your information.
After you have submitted the form, you will have the opportunity to securely upload and transmit images of patient x-rays.
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: POMS Facial Surgery Brier Creek Medical Building Phone Number 919-293-0299.