For Referring Doctors

Please fill out the CBCT referral form and fax it to 734-615-4784, e-mail it to dent-cbct@umich.edu or send it with your patient.

• CBCT Referral Form

For Patients

You will need a CBCT referral form provided by your referring doctor. Please either bring it with you or make sure that your doctor sends it to us prior to your appointment.

Please fill out the health history form and bring it with you.

• Health History Form