Referral Forms

The following programs require a referral from a dentist.

Referrals to the Graduate Programs Clinic

The Graduate Programs Clinic at UBC Dentistry accepts patient referrals for complex cases in endodontics, orthodontics, pediatric dentistry, periodontics, and prosthodontics.

Referrals to the Geriatric Dentistry Program

* The General Referral Form should be printed, filled in (by pen) and faxed to the Graduate Programs Clinic. The fax number is on the form.

** The Endodontics Referral Form can be printed, filled in (by pen), and faxed or it can be filled in online and submitted as an e-mail attachment. To fill in the Endodontics Referral Form online you must be using free Adobe Acrobat Reader as your PDF viewer. Other PDF viewers may not work.