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:

  1. Fill out form using your computer
  2. Save completed form to your desktop
  3. 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 Logo
  Treating our patients as we would our own families.

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.

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