Forms - Georgian Mall Dental Group
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Referral Form

Dental Forms

For your convenience, referring doctors and new patients are invited to complete the form prior to your first appointment. Should you prefer, you can also register in person upon check-in. Referring doctors may send the referral form via fax at 705-252-0779 or click on the secure encrypted patient referral form below.

For Referring Dentists
We would like you to consider us as part of your team in providing speciality services to your patients. We will work collaboratively with you, and other providers involved, to ensure continuity of patient care, and to develop comprehensive personalized treatment options that give your patients the best outcomes. Communication continues throughout the treatment process via reports, emails, and/or phone calls until such time that the patient is returned to your office for his/her maintenance care.

Request an appointment or call
705-252-7772
to book a consultation.

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