Referral Forms

Dr. Jeffrey M. Garcia and Dr. Kinan M. Al-Bitar are proud to welcome referrals here at Lake Country Periodontics & Implant Dentistry. We accept patients referred to us by a provider or self-referral. We invite you to fill out the form most suitable for your needs and give our periodontists and team in Waukesha and Mukwonago, Wisconsin, if you have any questions.

Doctor Referral Form

Self-Referral Form