Patient Referral Forms

Patient Referral Forms

Referrals are always welcome, however no referral is needed to come in for a free consultation.

gp referral.png

Primary Care Dentist Referral Form

GP Referral Form
Friend Referral Form.png

Friend Referral Form

Friend Referral Form
pediatric referral.png

Pediatric Dentistry Referral Form

Pediatric Dentistry Referral Form
oral surgery referral.png

Oral Surgery Referral Form

Oral Surgery Referral Form

Get in Touch!

707-525-1180

95 Montgomery Dr # 220 Santa Rosa, CA 95404

New patient? Special offer here!
Chat with us
Welcome to Victoria Lynskey!
We are open and offering complimentary new patient consultations.
How can we help?
I'm considering treatment
I’m a patient and need assistance
Excellent, I can help!
Good news, We're are now offering free In-Office Consultations
and, we can get you scheduled right away!
Click below to get started.
I'd like to set up an in-person consultation
I have a quick question - click to call Victoria Lynskey