727-799-6733 28469 US 19 N #401, Clearwater, FL 33761

Churney Periodontal ReferralsDr. Churney's office 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, his 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 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


Churney Periodontics Office Location

Take US 19 South. Go 1.25 miles after the Curlew intersection and MAKE A U-TURN at Republic Dr./Hammock Pine Blvd. RIGHT TURN into Auctioneer driveway. Follow drive around to back — Suite #401
Take US 19 North. Go past Countryside Mall. The next light will be Republic Drive/Hammock Pines Blvd. Travel .25 miles north. TURN RIGHT into Auctioneer driveway after Bob’s Carpet Mart. (Look for the orange roof.) Follow drive around to back — Suite #401
Churney Periodontics Dental Service 28469 US 19 North Suite 401
Clearwater, FL 33761