•  
    3033 Immel St Unit 500 Abbotsford BC V2S 6S2 CA

Now welcoming patients with Canadian Dental Care Plan (CDCP) coverage!

Refer a Patient

To refer a patient, please fill out a referral form using one of the options below.

We are thankful for your referrals and we will refer the patient back to you for future dental needs. A follow-up letter with be sent with details about the success of their treatment. Thank you for trusting us with the care of your patients.

- The Fraser Valley Dental Specialists Team

(604) 852-5402

Option 1

Complete Online 

Please complete the form below*. To share additional patient files, please call our office for more information. 

Option 2

Download PDF

Please download the appropriate PDF referral form and email or fax it to our office using the contact information on the form. 

Referral Forms

Patient Information

If Patient is a Minor

Reason For Referral

Referring Doctor

Dental Insurance

Secondary Dental Plan

*IMPORTANT: Any form submitted by email must be encrypted, to ensure it is secure. By submitting an unencrypted email form, you are consenting to an unsecured email. Alternatively, please call our office to refer a patient. 

Referral Form PDFs

Please download our PDF referral form and email or fax it to our office using the contact information on the form. 

General Referral

To refer a patient to Fraser Valley Dental Specialists, please fill out the form below.

Download Form

Endodontist Referral

To refer a patient to our endodontist, Dr. Moradi, please fill out the form below.

Download Form

Denturist Referral

To refer a patient to our denturist, Tanya Hunt, please fill out the form below.

Download Form

Orthodontist Referral

To refer a patient to our orthodontist, Dr. Wolk, please fill out the form below.

Download Form

Periodontist Referral

To refer a patient to our periodontist, Dr. Ahmadi, please fill out the form below.

Download Form

Oral Surgeon Referral

To refer a patient to our oral surgeon, Dr. Dahlman, please fill out the form below.

Download Form

The Road to a Healthy Smile Starts Today

Get in touch! No referral needed.

Request Appointment

(604) 852-5402