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Please note: A referral from a physician, a nurse practitioner or a dentist is needed to visit this clinic.

Referrals form

Referrals process

Complete the referral form

  • Please complete the referral form 
  • Fax the completed form to 604-875-2812.

2Email relevant images

  • Please email any relevant images
  • These images will assist our team in gaining a preliminary understanding of the patient's situation

3Wait for appointment

  • Please don't contact us for updates regarding the appointment scheduling.
  • We will contact the patient directly with any updates as soon as they are available. 

SOURCE: Dentistry ( )
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