REFER A PATIENT

Refer a patient

Send a referral to Auckland TMJ Centre. We confirm receipt and triage within one business day.

Complete the referrer and patient details below. Attach X-rays, CBCT, MRI, or referral letters if available. For urgent referrals, please call the practice directly.

Full name of referrer

Referrer Clinic

Phone Number of referrer

Email of referrer

Patient Details

Patient's First Name

Patient's Last Name

Patient's date of birth

Patient's gender

Patient's Phone Number

Patient's email

Patient's address

City

Does the patient have insurance?

Yes No

Comments

Please attach any relevant files

Up to 4.5 MB total across all three files. PDF, DOC, DOCX, JPG, or PNG. For larger uploads (CBCT, MRI), please email directly to info@aucklandtmjcentre.nz.

File 1

File 2

File 3

By submitting, you agree to be contacted by Auckland TMJ Centre about your enquiry. We do not share your information with third parties.

Prefer to email or call your referral through? You can also send a referral letter directly.

Phone +64 9 477 0058
Email info@aucklandtmjcentre.nz

Same surgeons

OMS Specialists

When surgery is required, it is carried out at OMS Specialists, our co-located oral and maxillofacial surgery practice. Same surgeons, same accredited facility, full-scope surgical care across jaw, facial, oral, and skin conditions.

Visit OMS Specialists