Patient Referral Form

Download our fillable referral form, then send it with any records by secure email to office@nobhilldental.net or by fax to (503) 365-9713. You can also send the form with your patient. Questions? Call (503) 364-9515.

Download Referral Form (PDF)

Nob Hill Dental is a Salem dental practice built around a simple idea: your teeth deserve careful, conservative work that lasts. Dr. Alexander Zuk practices adhesive and biomimetic dentistry — techniques that preserve more of your natural tooth, reduce post-treatment sensitivity, and extend the life of both your restorations and the teeth beneath them.