Secure, Online Referral Form

You may refer patients to our office by filling out our secure online Referral form. After you have completed the form, please make sure to press the Complete and Send button at the bottom to automatically send us your information. The security and privacy of patient data is one of our primary concerns and we have taken every precaution to protect it.

Secure online Referral Form

Endodontic Referral Form

CBCT Referral Form

CBCT Order Report Form

Portal for Referring Doctors

Referring Doctor Portal Login

For assistance, please call us in Strathroy at Strathroy Endodontics Phone Number 519 245 7070.

Office Hours

Monday through Thursday:   9:00 AM - 4:00 PM
Friday:   9:00 AM - 2:00 PM