Dentist Referral Form
Thank you for referring your patient to Braces Doc. Please complete the referral form below and include any available radiographs or additional information to help us prepare for your patient's orthodontic consultation.
REFER A PATIENT FOR ORTHODONTIC CARE
Submit a Patient Referral
Patient Referral Form
We have successfully received your Dentist Referral Form. Our team will review the information and any accompanying radiographs before contacting the patient to arrange the next steps, if appropriate.
If you have additional information to provide or need to discuss the referral with our team, please contact Braces Doc at (613) 634-2216. We appreciate your confidence in our orthodontic clinic and look forward to caring for your patient.
Oops, there was an error sending your message.
Please try again later.
Please try again later.
