Dr. Hugh Maguire Your Endodontist - Specialized Dental Care
Referrals Dr. Hugh Maguire,endodontist,dentist,vancouver,bc, D.M.D., M.S. (Endo.), Cert. (Endo.), FRCD (C)
   
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We gladly accept referrals from throughout the Province of British Columbia , Canada and the United States . If you are happy about the service your patients have received from our office, please tell your colleagues. We always welcome new dental offices to our network of quality, caring, dental service providers.

Referral Form

Referring Doctor's Name:
Referring Doctor's Email:
Patient's Name:
Patient's Phone Number (Home) (Work)
Tooth #
Today's Date


PATIENT'S STATUS

Patient is in pain please treat as soon as possible
Root Canal treatment is required
Root Canal treatment has been started, please complete
Patient has vague pain, please evaluate

RESTORATION REQUEST

Temporary
Amalgam
Composite
Post and Core
Post Space

Remarks regarding the case.

Please submit this form, a copy of your referral will be sent to your email address, please print out the email and retain for your records

Print out this page and give to the patient.

 

239 1959 152nd St
White Rock, BC, V4A 9E3
Phone: 604-531-3631 Fax: 604-531-3675
info@drmaguire.com