Endodontics:  Referral Forms

If you are a new patient
Your Dentist will need to complete a referral form and send a copy of a current x-ray to the Department of Endodontics as soon as possible.  Please put the appointment time and date on the referral if you already have an appointment.  Referrals can be sent by using one of the following methods:

Electronic Endodontic Referral located at Patient Care>Information for Providers>Patient Referral Forms https://www.dentistry.uiowa.edu/form-endodontics-referral
Printable Endodontic Referral located at https://www.dentistry.uiowa.edu/sites/default/files/docs/referral/referral_endodontics.pdf - this can be sent one of the following ways:
*Fax:  (319) 335-9663
*Mail:  University of Iowa - College of Dentistry
           Department of Endodontics W305
           801 Newton Road
           Iowa City, Iowa  52242

Please do not forget to send your most current x-ray/film/image/radiograph with your referral form