Referral Forms

Please click on the link below to print our referral form. You may also fill in the information online and email directly back to us at

Please be sure to include full name and contact information (phone number and address) if sending via email. Please also CC the patient in the email.

We look forward to serving your dental needs. If you have any questions concerning the information seen here or to schedule an appointment with Dr. Colin P. Lentz, DDS at Lanier Valley Dentistry, please contact us at or (678) 802-1209 or (678) 4-LENTZ-4, and we will be happy to help you.