Referring Information and Forms

Treatment at PDI

Because all surgery at PDI Surgery Center is performed under general anesthesia, referrals must come from a dentist or primary care physician. You may contact PDI offices to request a copy of the referral form, or download the PDI Referral Packet here.


(Toll Free) 1-877-934-7372

(Main Line) 707-838-6560

(Fax) 707-838-8464


Below is a partial list of health centers and referring partners: 


Sonoma County

Alliance Medical Center (Healdsburg)

North Bay Regional Center (Santa Rosa)

Petaluma Health Center (Petaluma)

St. Joseph Dental Center (Santa Rosa)

Russian River Health Center (Sonoma)

Santa Rosa Health Center  

Southwest Health Center (Santa Rosa)

Napa County          

Clinic Olé/Sister  Anne

Community Dental Clinic

North Bay Regional Center

Queen of the Valley Dental Van

Mendocino County

Anderson Valley Health Center (Boonville)

Long Valley Health Center (Laytonville)

Mendocino Community Health Clinics (Ukiah and Willits)

Mendocino Coast Dental Clinic (Fort Bragg)

Redwood Coast Medical Services (Gualala)

Redwood Coast Regional Center (Eureka)

Potter Valley Community Health Clinic (Potter Valley)

Consolidated Tribal Health Center (Redwood Valley/Ukiah)

Healthy Start (Fort Bragg, Laytonville, Ukiah)

Lake County

Mendocino Community Health Clinic (Lakeport)

Adventist Health Redbud Clinic (Clearlake)

Healthy Start (Lakeport)

Healthy Start/Lake County Public Health

Mobile Dental Van

Lakeside Health Center

Marin County

University of Pacific

Marin County Dental Society

Marin County Dental Clinic

Children’s Oral Health Project Marin

College of Marin



Download the Patient's Rights and Responsibilities form here:



If you have questions, please call us! We are happy to answer any questions you may have regarding the PDI Referral Packet, our services, outreach information or finding a dental home for your child.