Bilingual — Spanish

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Do you have a patient in need of periodontal services or dental implants for a missing tooth? If so, Dr. Jeffrey M. Garcia and Dr. Kinan M. Al-Bitar are happy to accept any referrals here at Lake Country Periodontics & Implant Dentistry. Fill out the form below and give us a call if you have any questions for our periodontists and team in Waukesha and Mukwonago, Wisconsin.

Printable Doctor Referral Form

PDF Doctor Referral Form
Word Doctor Referral Form

Here is were you can upload the printable doctor forms and attach x-rays as well!

Online Doctor Referral Form

Doctor Referral Form

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Two Locations To Better Serve You

Waukesha Office

2316 N. Grandview Blvd.
Waukesha, WI 53188

MUKWONAGO Office

400 Bay View Road Suite K
Mukwonago, Wisconsin, 53149