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Refer a Patient

To refer a patient, please fill out a referral form below.

We are thankful for your referrals and we will refer the patient back to you for future dental needs. A follow-up letter with be sent with details about the success of their treatment. Thank you for trusting us with the care of your patients. - The Cloverdale Dental Team

(416) 236-2304

Patient Information

Referring Office

Your email address will be used to send you a confirmation of receipt and/or consultation report.

Referral Information

*IMPORTANT: Any form submitted by email must be encrypted, to ensure it is secure. By submitting an unencrypted email form, you are consenting to an unsecured email. Alternatively, please call our office to refer a patient. 

Providing Healthy Smiles For Over 30 Years

Progressive Methods. Caring Approach. We're happily accepting new patients at our dental clinic! Contact us to get started today. 

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(416) 236-2304 Request Appointment
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