Refer a Patient: Student Clinic

How to refer a patient to the College of Dentistry's student clinics:

To refer a patient to the College of Dentistry's student clinics, please use the below form.

Please note:

We are accepting referrals, but at this time our appointment openings are limited. Referred patients may have to wait longer than normal to be seen at the College of Dentistry. Thank you for your patience and understanding.

To Refer or Submit Radiographs: Download and complete the Patient Information Form. Save the completed form where you can easily access it, like on your desktop. Upload the completed form and radiographs below.

STEP 1: Submit the completed Patient Information Form below. In the Description Box, put the Patient's Name.

STEP 2: Submit images and radiographs below. In the Description Box, put the Patient's Name.