Referral Form

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 for your referrals

Referral Form