Contact Us

Contact Us

Referrals

Clarence Street Dental is happy to accept external referrals for our specialists.
We offer services with our Pediatric Dentist, Orthodontist, Oral Surgeons, Endodontist, Periodontist, and Denturist, as well as CBCT Scans.

If you are a patient and would like to refer yourself to Clarence Street Dental, please complete this form and either email it to clarencestreetdental@gmail.com or fax it to 519-756-0745. One of our patient coordinators will contact you to make the referral.

If you are referring a patient to Clarence Street Dental, please complete the form below for the required specialty and either email it to clarencestreetdental@gmail.com or fax it to 519-756-0745. One of our patient coordinators will contact your patient to make the referral.

Dr. Monika Srivastava

Pediatric Referral Form

Dr. Diogo Guerreiro

Endodontic Referral Form

Dr. Jacob Swiderski

Periodontic Referral Form

Drs. Andy Wong and Ron Ho

Oral Surgery Referral Form

Mr. Carm Cino

Denture Referral Form

CBCT Scan

Referral Form

Have you scheduled your next appointment yet?

X