top of page

Online Referral

Online Form - For Dental Professionals Only*

*for patients wanting to book an appointment, please have your dentist send a referral to our office.



Referring Dentist:*

Dentist Email:


Phone Number

Examination requested for:


Indicate area(s) of concern:*

Patient Name:*

Telephone Number:

Date of Birth:


Upload File

Feel free to use our downloadable referral form for Vancouver or for Dr. Han’s satellite office in Abbotsford.

bottom of page