Refer a patient to us by downloading our Referral Form and sending to our office.
Download Referral Form PDF from the list below:
↓ Referral Form for Crystal Lake Oral Surgery
↓ Referral Form for Lake Geneva Oral Surgery
↓ Referral Form for Huntley Oral Surgery
↓ Referral Form for Burlington Oral Surgery
Directions for Forms:
- Fill out form using your computer
- Save completed form to your desktop
- Email as an attachment to preferred office
Alternatively, download PDF, print and fill out by hand, and mail or fax to preferred office.
Crystal Lake Oral & Maxillofacial Surgery
Doctors Conlon, Bruksch, Ozment, Richard, Fay and Schmidt
690 N. Route 31
Crystal Lake, IL 60012
Phone: 815-459-5600
FAX: 815-459-5601
Office Hours
Monday – Friday 8:00 am – 5:00 pm
Saturday 8:00 am – noon
Hours may vary occasionally due to hospital surgery and emergencies.