Dr. Jennifer E. Lohse
Periodontics and Implantology
904 Coleman Boulevard
Mount Pleasant, SC 29464
This section pertains to Dentists only.
For your convenience we have our referral form online for you to download and print. These forms are normally in triplicate with copies for Referral, Patient and Doctor. Please complete the referral with as much information as possible, this will eliminate unnecessary phone calls to your office.
When completing the referral form, please pay attention to the following items:
Please fax (843-971-1686) or mail a copy of the referral to our office to facilitate your patientís evaluation. Please retain a copy of the completed referral form for your records.
Click on the link below, and then go to File and Print
You will need Adobe Acrobat to view this document.
Check out information on our new Laser Periodontal Therapy!