To submit a referral, please enter the details of your patient below. Upon pressing submit you will be provided with a link to our secured portal for uploading any additional files and information.

If your matter is urgent please contact the practice on (02) 6622 6750 to ensure your patient is seen the same day or as soon as possible.

If our referral form does not display below, please CLICK HERE to go complete the form.

Phone: (02) 6622 6750   Fax (02) 6622 6752

21 Dalley St, East Lismore NSW 2480, Australia

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©2016 by Northern Rivers Oral & Maxillo Facial Surgery         LISMORE   GRAFTON   BALLINA   COFFS HARBOUR.