Thank you for trusting us with your patients.

Our goal is to make the process easy and seamless to refer your patients to our practice. We will treat your patients like family and meet their health needs and exceed their expectations.

If you have any questions before sending your patients to our practice, please do not hesitate to reach out to us by phone:

Silverdale: 360-979-1537
Auburn: 253-352-4430

or email at:

Dr. Kushner: tkushner@tmjsleepsolutionsnw.com
Dr. Kwolek: gkwolek@tmjsleeepsolutionsnw.com

and please fax any information to:

Silverdale: (360) 779-7732
Auburn: (866) 861-6286

Please complete the form below.

Referring Doctor(Required)
Patient Name(Required)
MM slash DD slash YYYY

TMJ

Please check all that apply for the patient being referred:
Pain
Other TMJ Info
Requested TMJ Services

Sleep Disorders

Please check all that apply for the patient being referred:
Sleep Disorder Info
Requested Sleep Services