Referral Form
You may refer endodontic patients to our office by printing and filling out our Referral Form below.
If you have any questions, please call our Salem office: Salem VA Endodontic Office Phone Number 540-989-6648.
Office Hours
Monday through Friday: 8:00 AM - 5:00 PM
Technical Note
This form is in PDF format. If you do not have Adobe Reader installed on your computer, you may download Acrobat Reader for free and use it to access our Patient Referral form.