DDS Patient Referral Form

Please complete this form below


Our Office Locations

Victoria

#206 - 4480 W. Saanich Road

Victoria, BC V8Z 3E9

250.479.4645

Duncan

Suite 211, 35 Trunk Road

Duncan BC V9L2P5

250.746.4011

Sooke

6689 Sooke Road

Sooke, BC V9Z 1A5

250.479.4645

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Orthodontic Examination

Patient First Name* Required field!
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Radiographs: Upload Here Required field!
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Insurance Information* Required field!

Directions to our offices

Victoria

Royal Oak Shopping Centre:

Above LifeLabs and Subway

Duncan

Scotia Bank Building on Trunk road

Sooke

Same building as Academy Dental and Mason Financial

Forms & Brochures

While no dentist referral is necessary, we do ask that all of our new patients complete our New Patient Form prior to their first visit.

New Patient Form

Download, print, and fill-in before your first appointment.

Financing/Payment Plans

We understand that cost can have a huge influence on whether or not you pursue orthodontic treatment so Dr. Bartlett is pleased to provide direct billing to your insurance company. Fees not covered by insurance plans can be paid in monthly installments.

We are always happy to discuss various options to ensure we can accommodate your needs. Try out our fee calculator, or get in touch with us today!

Orthodontic Emergencies

For a list of the most common orthodontic emergencies and their treatments, please find the attached documentation from the American Association of Orthodontists. If you are experiencing an orthodontic emergency, please contact our offices immediately.

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