Online Referral Form

You may refer patients to our office by filling out our secure online Referral Form. After you have completed the form, please make sure to press the Submit button at the bottom to automatically send us your information. 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 button

For more information, or to schedule a consultation with Drs. Gorme and Chritah, call our office in Baytown, TX at Baytown Oral & Maxillofacial Surgery Associates Phone Number 281-422-0511, or request an appointment online.