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. Please complete the appropriate form and fax it to 519-756-0745 or email it to

Dr. Monika Srivastava

Pediatric Referral Form

Drs. Andy Wong and Ron Ho

Oral Surgery Referral Form

Dr. Diogo Guerreiro

Endodontic Referral Form

Dr. Jacob Swiderski

Periodontic Referral Form

Mr. Carm Cino

Denture Referral Form


Referral Form