Churney Periodontal welcomes referrals from both colleagues as well as patients.

We are grateful for your confidence in our collaborative relationships and will strive to support our patients and their referring doctors in every way possible.

Thank You!
If you are a new referring doctor, thank you for your confidence in our treatment for your patient. Please take the time to read more about Dr. Churney or Dr. Adams, their staff, and their philosophy on care and treatment.

If you are a returning referring doctor, thank you as well for your continued support. We will provide excellent periodontal care for your patients, while helping to support their ever improving dental health.

In an effort to better serve our referring doctors, we have redesigned our referral form to streamline the referral process as much as possible. We have also included (see back of form) a detailed map and driving directions to assist patients in finding the office with greater ease.

Please feel free to give Dr. Churney or Dr. Adams a call directly to discuss your patient, their case, or treatment options at anytime.

Download Referral Form
Click here to download our Referral Form
(PDF Form with small Map & Driving Directions)

After you have completed the form, please fax the completed Referral Form to Dr. Churney’s Office at:  727-726-9157