Referral forms

Refer a patient to Comfy Denture & Hearing Clinic

We welcome referrals from physicians, dentists, and other healthcare providers. Download and complete the appropriate form below, then fax or email it to your nearest location.

Working together for better patient outcomes

Our team of specialists — including Dr. Min S. Kim (Maxillofacial Prosthetist/Denturist) and Jieun Kim HIS (Hearing Instrument Specialist) — partners with referring providers to deliver seamless, coordinated care. We'll keep you informed at every stage of your patient's treatment.

Forms

Download referral forms

General denture referral

For patients requiring complete dentures, partial dentures, immediate dentures, or denture repairs and relines.

Denture Referral Form (PDF)

Contact us if you need this form emailed directly.

Implant denture referral

For patients who have received or are planning dental implants and require implant-supported dentures.

Implant Denture Referral Form (PDF)

Contact us if you need this form emailed directly.

Maxillofacial prosthetics referral

For patients requiring obturators, palatal lift prostheses, ocular, orbital, auricular, or nasal prosthetics, or custom radiotherapy masks.

Maxillofacial Prosthetics Referral Form (PDF)

Contact us if you need this form emailed directly.

Hearing aid referral

For patients requiring hearing aid assessment, fitting, or L&I hearing aid claims. Jieun Kim HIS is an approved Washington State L&I provider.

Hearing Aid Referral Form (PDF)

Contact us if you need this form emailed directly.

Process

How to submit a referral

01

Download the form

Select the appropriate referral form above and download the PDF.

02

Complete patient details

Fill in the patient's name, date of birth, contact information, diagnosis, and any relevant clinical notes.

03

Send to your nearest location

Fax or email the completed form to the Comfy Clinic location most convenient for your patient. Contact details are listed below.

04

We'll contact the patient

Our team will reach out to the patient within one business day to schedule their appointment and confirm insurance or payment details.

Locations

Send referrals to your nearest location

Federal Way

30818 Pacific Highway South, Federal Way, WA 98003
(253) 839-1505[email protected]

Bonney Lake

18802 Mountain View Drive East, Bonney Lake, WA 98391
(253) 750-4164[email protected]

Kent

308 Washington Avenue South, Kent, WA 98032
(253) 981-3917[email protected]

Questions about a referral?

Call our toll-free number or use our contact form and our team will be happy to assist.