For referring dentists
Refer a patient
Send us the case and we will take it from there. You receive a written assessment and a treatment plan, and your patient returns to you for restorative care.
This form is not active on the preview site yet. To reach the clinic today, call (514) 933-7277 or email laclinicperio@gmail.com.
Please do not attach radiographs or clinical images to this form. Send imaging by secure transfer, or have the patient bring it to the consultation. We will confirm receipt of every referral.