Referral Forms

This page is for doctors and staff who refer patients to Fallon Oral Surgery of Syracuse. Our goal is offer an alternative way of obtaining referral forms electronically, ease the referral process, reduce wait times and ultimately increase overall patient care.


  • 1) Select a referral form
  • 2) Print referral form
  • 3) Fill out
  • 4) Send to our office via email, fax or via patient.

Please contact our office directly with questions or concerns.

Click on the below links to open forms:
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West Taft Medical Park  •  4820 West Taft Road  •  Liverpool, NY 13088  •  315-451-6988
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