Skip to main content


If you are a healthcare provider and would like to refer a pediatric patient to Daydreams for dental treatment under anesthesia, please complete the patient referral form below. When you submit this form, an e-mail will automatically be sent to the patient’s parent/guardian with information about scheduling the initial consultation.

  • Referring Provider

  • Patient Information

  • Attach Files
  • On behalf of the Daydreams team, we thank you for your referral and trust.

  • Should be Empty:

Daydreams Procedure Center is a QUAD A accredited facility, having met the standards of a CLASS C ambulatory surgery facility with a focus on patient safety and industry best practices.