What is the referral process?

  • Please complete the Agency Referral Form. Provide as much information about the patient as possible.
  • Fax referral form to our Waukesha clinic at fax number 262-522-2828 OR our Menomonee Falls at fax Number 262-502-0508.
  • Patients will be scheduled for appointments by the Community Smiles Dental staff after eligibility is confirmed.
  • OB/GYN medical providers should use our OB/GYN Referral Form to refer pregnant patients to our clinics