Refer a patient to us by downloading our Referral Form and sending to our office.

Download Referral Form PDF from the list below:

↓ Referral Form for Huntley Oral Surgery

↓ Referral Form for Crystal Lake Oral Surgery

↓ Referral Form for Lake Geneva Oral Surgery

↓ Referral Form for Burlington Oral Surgery

Directions for Forms:

  1. Fill out form using your computer
  2. Save completed form to your desktop
  3. Email as an attachment to preferred office

Alternatively, download PDF, print and fill out by hand, and mail or fax to preferred office.

OMS logo in white outline
Treating our patients as we would our own families.

Huntley Oral & Maxillofacial Surgery
Doctors Conlon, Bruksch, Ozment, Richard, VanOven and Fay

11650 S. Route 47
Huntley, IL  60142
Phone: 847-669-2900
FAX: 847-669-2620

Office Hours
Monday – Friday 8:00 am – 5:00 pm
Saturday 8:00 am – noon

Hours may vary occasionally due to hospital surgery and emergencies.