Dental Referrals Vancouver

We welcome referrals and are delighted to work closely with our referring colleagues for all aspects of prosthetic dentistry, implant dentistry, cosmetic dentistry, oral surgery, periodontics, and endodontics. We are also available to help you decide which would be the best option for your particular cases.

You can fill out the online form below or directly contact our Vancouver office at 604-336-0958 to discuss a case and refer a patient, for your convinience PDF/Word referral forms are available for download, please either fax (604-336-0959) or email it to us at

Patient Referral Forms

Patient Online Referral

    Patient Information

    Date of Birth:

    EmailedTake new
    Please arrange the requested Consult/Treatment and refer the patient back.
    Consult OnlyConsult and Treat

    Relevant important Medical and Dental history:

    Reason for Referral:

    Oral SurgeryPeriodonticsImplantEndododonticsProsthodontics

    Cone Beam CT Acquisition:

    Full ArchDouble Arch

    Patient information will be used by Vancouver Dental Specialty Clinic for the sole purpose of returning your request to be contacted by us. Vancouver Dental Specialty Clinic takes no responsibility for web communication.

    3488 West Broadway

    Vancouver, BC, V6R 2B3


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