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Web patient referral form — dentist to physician. Wf 10355 may 21 w003913. Web access the current provider press by selecting quickpoints from the category dropdown menu below, then type provider press in the search field. Web paramus 545 route 17 s paramus nj 07652phone 201.527.6699fax 201.527.6690 cardiology critical careemergency medicineinternal medicineoncologysurgery reason for referral immediate history/medications concurrent conditions previous diagnostics* (please fax or email) *please enclose copies of all pertinent diagnostics.