Patient Forms

Oasis Prosthodontics welcomes all patient referrals. If you would like to refer a patient to Dr. Funtik, please download and complete the form below:

Referral Form (click here)

The completed referral form can be…

Emailed to us at:

[email protected]

Mailed to us at:

685 Citadel Dr. East
Suite 313
Colorado Springs, CO 80909

Faxed To us at:

(719) 574- 6530

Or given to the patient, if you have already scheduled their appointment with us by calling ahead.

If you are having trouble downloading the form, feel free to call our office directly to discuss referrals.