Dentist Referral

REQUEST AN APPOINTMENT

Dentists / Doctors - Click here to download our Doctor Referral Form

Please download the form (above), complete and email it to info@nsortho.ca. Please attach relevant x-rays.


Are you a patient or looking to book an appointment? Fill in an appointment request!

*Items in bold are required.
Are you a current patient?


Preferred day(s) of the week for an appointment?

Preferred time(s) for an appointment?

Please describe the nature of your appointment (e.g., consultation, check-up, etc.):

Note: Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private information.

Healthy Smiles

What does your smile say about you? Let us help you radiate confidence with a healthy smile.

Testimonials