Please fill out this Clinician Referral Form for your patient to bring to their appointment.

Referral Form


Dr. Benavent sees patients by appointment only.  Please call 443-535-9600.

The appointment


What to send

If available, please provide your patient with copies of any recent dental radiographs, head & neck imaging, serology reports, or pathology reports.  These can also be sent in digital format directly to Dr. Benavent once your patient has set up their appointment.


We look forward to caring for your patient, and we thank you for your trust.