Email us at ✉️ info@tonguetiecenterofgeorgia.com | Call us today 📞 770-all-hugz (255-4849)

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Secure Submission

Patient Referral Form

Please provide the patient's details below. Our team will contact the family directly to schedule their consultation.

📞 770-all-hugz (255-4849)

✉️ info@tonguetiecenterofgeorgia.com

Your privacy matters to us. See our Notice of Privacy Practices for details on how your information is collected, used, and protected.

Seamless Care

How Provider Referrals Work

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Submit Referral Info

Patient Outreach

Collaborative Report

Fill out our secure online form below with patient details, primary symptoms, and contact information.

Our clinical coordinator contacts the family promptly to schedule a full consultation and explain treatment options.

Following evaluation or treatment, we send detailed clinical updates to your office for continuous co-managed care.

Provider Collaboration

Refer a Patient for Frenectomy Evaluation

We partner with pediatricians, lactation consultants, and dentists across Georgia to deliver gentle, specialized laser frenectomy care for infant and pediatric tongue ties.