Clinique Endodontique Mont-Royal

Referring dentists – form

Referring Dentists

We propose the following two methods to refer a patient.
These methods may help prevent a consultation before treatment.


Complete the referral request on-line

On-line referral form

Please print the referral request (PDF)
and send the completed form and x-rays by mail.

Download the referral request (PDF)

Need more referral forms?

Give the referral form directly to your patient who will contact us.
We will then schedule a consultation appointment.

Download the referral request form (PDF)