• REFERRAL FORM

    For Dental Practitioners

    Please use this convenient Dental Referral Form below to refer any patient to us. Thank you very much! We look forward to working with you.

  • Patient Information

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  • Referral Information

  • Reason for Referral

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    Apple Denture & Implant Solutions
    Port Hope Clinic: 121 Peter Street, Port Hope, ON, L1A 1C5
    Toronto Clinic: 2130 Lawrence Ave E., Unit 104, Scarborough, ON, M1R 3A6

    905-885-2121
    forms@appledentures.ca