604-636-2686
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For Referring Dentists

Dentist Referral

We welcome referrals from general dentists and other healthcare professionals. Tsai Orthodontics is committed to clear communication, thoughtful follow through, and respectful coordination with the referring office.

Printable Referral Form

Prefer a printable form?

Download our referral form and complete it by hand, then fax, email, or send it with the patient.

PDF · 1 page

Tsai Orthodontics Referral Form

Standard letter-sized form. Print, fill out, and send.

Submit a Referral

Refer a patient to our practice.

Complete the form below. Submitting opens your email client with a pre-filled, professional referral to smile@tsaiorthodontics.ca. We will confirm receipt and follow up with your office once the consultation is scheduled.

Orthodontic Referral
CERTIFIED SPECIALIST IN ORTHODONTICS

Dr. Andrew Tsai, DMD, MSD, FRCD(C)
3431 Main Street, Vancouver, BC V5V 3M9
Phone: (604) 636-2686

Referral Urgency

Referral Urgency

Referral Urgency
Patient

Patient

Language Preference
Referring Doctor / Practice

Referring Doctor / Practice

Reason for Referral

Reason for Referral

Clinical Notes

Clinical Notes

Enclosures & Dental History

Enclosures & Dental History

Panoramic X-Ray
Pending Dental Treatment Before Ortho?

Complimentary consultations available. We welcome your patients and value your trust in our care.
Completed referrals should be submitted to: smile@tsaiorthodontics.ca

How we work with you

Coordinated, transparent, collaborative.

Specialist Coordination

Direct line to Dr. Andrew Tsai for case discussions and complex referrals.

Transparent Communication

Treatment letters, progress updates, and post-treatment summaries shared promptly.

Collaborative Care

Restorative, periodontal, and airway colleagues welcome — we plan together.

Questions about a referral?

Contact our office directly.

Address
3431 Main Street
Vancouver, BC V5V 3M9
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