Referral Form

We appreciate your referral!

We value our referring physicians and are proud to partner with you in providing your patients excellent Orthodontic, TMD, Snoring and Sleep Apnea care. To refer a patient, simply complete the referral form and send it to [email protected] or fax it to 519-455-4779. We will send you a full report on each patient regarding our diagnosis and proposed treatment plan. Thank you!