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 Referral Forms for Oral Medicine / Oral Pathology

Patient Online Referral

Referral to Doctor
Please arrange the requested Consult/Treatment and refer the patient back.
Consult OnlyConsult and Treat

Patient Information

Date of Birth:


EmailedTake new

Relevant important Medical and Dental history:

Cone Beam CT Acquisition:

Full ArchDouble Arch

Reason for Referral:

Oral SurgeryPeriodonticsImplantEndododonticsProsthodonticsOral Medicine Oral Pathology

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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