Referral Forms

Give referring dentists a better way to send patients.

Secure online referral forms in place of fax and unencrypted email. Every referral lands in your SendVyte inbox.

HIPAA compliant — BAA includedIncluded in SendVyte Specialty
Built for dental specialistsHIPAA compliantBAA includedReplaces faxLands in your inbox

Referrals still arrive the hard way.

Referring offices still send patients by fax and email, and your team spends the morning piecing referrals back together.

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Faxes get lost or arrive unreadable

A smudged slip means a call back to the referring office before anyone can help the patient.

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Patient details sent by unencrypted email

Convenient for the referring office, and a privacy risk for both practices.

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Missing information means phone tag

No callback number, no reason for referral, no insurance, and the patient waits.

From referring office to your inbox in three steps.

A secure form replaces the fax machine.

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STEP 01

Share your secure form

Share your secure referral form with referring offices.

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STEP 02

The office sends the referral

The referring office sends the patient and referral details through the form, from any browser.

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STEP 03

It lands in your inbox

The referral lands in your SendVyte inbox for your team to follow up.

New referral
Referring dentistDr. Jordan Ellis
PracticeMaple Grove Family Dental
PatientSam Rivera
ReasonEvaluate #19 for root canal
InsuranceGiven by office
Example with demo data

What the referring office fills in, and what your team sees.

The referring office completes the secure form. Your team gets an inbox item with the referral details, ready to follow up.

Secure referral forms built for endodontics, periodontics and oral surgery.

Secure referral intake for endodontic, periodontal and oral surgery practices. Pair it with Dentist Referral Marketing to see each referring dentist’s history in one place.

New patients can request appointments the same way.

A secure appointment-request form lets new patients ask for an appointment from your website. Requests land in the same inbox, and your team confirms every appointment.

Replace unencrypted email with a HIPAA compliant form.

SendVyte is HIPAA compliant, and a BAA is included with every plan. Referral details travel through a secure form instead of fax or unencrypted email, and your team views them in the app.

See the form your referring dentists would use.

Open our demo referral form and send a practice referral with made-up details. Then see what the specialty practice receives. Copperleaf Endodontics is a fictional practice created to demonstrate SendVyte.

Questions about Referral Forms

Yes. SendVyte is HIPAA compliant, and a BAA is included with every plan.
Into your SendVyte inbox, where your team follows up.
Yes. The secure appointment-request form lets new patients request an appointment, and your team confirms it.
Yes. Referral and appointment-request forms are included in SendVyte Specialty.
Yes. Referral forms are built for endodontic, periodontal and oral surgery practices.

See the referral form your referring dentists would use.

Book a demo and we’ll walk through the form and the inbox with you.