Online Referral Form
For dental offices and prospective patients
A PDF version of this form can be downloaded below or call the office to refer yourself or a patient in person.
Numbers Speak
1
K+
Patients
Cared
For
Cared
For
1
+
Years of
Service
Service
1
+
Research
Publications
Publications
how can we help you?
Contact us
If you have any questions or comments please call our office to speak to one of our team members. Alternatively, you can complete our online contact form below and a member of our team will reach out to you as soon as possible.
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165 Highway 20 West,
Fonthill, ON L0S 1E5 -
Phone: 905.892.0800
Fax: 905.892.0005 - [email protected]
- Mon-Thurs: 8:00am - 4:30pm