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Just4Kids Pediatric Dentistry Dr. Wendy Tang Certified Specialist in Pediatric Dentistry

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Dental Referral

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A successful practice doesn't just happen. It is the result of a strong commitment to excellence in our treatment and in our relationships with patients and doctors. We'd like to take a moment to thank you for showing your confidence in our practice by recommending us to your friends, family, and colleagues. We're gratified to find how many new patients regularly call on us based on your words of advice.

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Doctor Referral Form

If you are a doctor who is referring a patient to us, please fill out and submit the following form.

Your Information:

Your Name:

First

Last
Your Practice Name:

Full Practice Name
Email Address

Valid Email Address

Referral Information:

Name of Person You're Referring:

First

Last
Were Radiographs Sent?

Yes No

When were they sent?
Additional Information:

Comments:

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Verification Code: (case sensitive)

Just4Kids Pediatric Dentistry provides general dentistry for children in Vancouver, Surrey, and Langley, BC. Dr. Wendy Tang and Dr. Amy Bellamy offer general dentistry for infants and children. Contact Just4Kids Pediatric Dentistry to schedule an appointment.

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Just4Kids Pediatric Dentistry Dr. Wendy Tang Certified Specialist in Pediatric Dentistry

Dental Referral

Choose a form:

Your Name:

Your Practice Name:

Email Address

Name of Person You're Referring:

Were Radiographs Sent?

Additional Information:

For Security Purposes, Please Enter the Code Below:

Just4Kids Pediatric Dentistry provides general dentistry for children in Vancouver, Surrey, and Langley, BC. Dr. Wendy Tang and Dr. Amy Bellamy offer general dentistry for infants and children. Contact Just4Kids Pediatric Dentistry to schedule an appointment.