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22 Queen Street North, Tottenham, ON L0G 1W0

For Doctors

Thank you for your confidence in referring your patients for sedation dentistry.

Tottenham Sleep Dentistry is committed to our dental community and the strong connections we have built with our professional colleagues and their patients.

Your trust in our sedation services and your referrals are truly appreciated.

If you're considering referring a patient for sedation dentistry, please share the required details below. After filling out the form, just click "SUBMIT" at the bottom of the page. We highly value your partnership in delivering outstanding care to your patients.

Referral Form

Patient's Name:
Parent / Guardian's Name
Phone:
Cell:
Referring Office:
Referring Doctor:
Office Phone:
 
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