Refer a Patient You may refer patients to us by filling out the form below or by calling our office at 262-232-8777. Thank you! Please enable JavaScript in your browser to complete this form.Referring Doctor *FirstLastDoctor's Email *Doctor's Clinic Name *Clinic Phone Number *Clinic Fax NumberPatient Name *FirstLastPatient Phone Number *Patient EmailPatient's Medical Insurance (ie. BCBS, UHC, Medicare)What is the patient being seen for? *TMJSleep ApneaTell us about your referral:Send Looking for TMJ pain relief? We'd love to help you! Schedule Appointment