Online Referral Form

Thank you for choosing Oral-Facial Surgery, PA and Dr’s Hughes and Clark! To refer patients to our office, please complete our secure online Referral Form or FAX a Paper Referral Form to 320-235-6097. If you have completed the online form, please make sure to press the “Complete” and the “Send” button at the bottom of the form. The security and privacy of patient data is one of our primary concerns and we have taken every precaution to protect it.

Online Referral Form