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    • Dr. Tassos Irinakis
    • Dr. Eleni Irinakis
    • Dr. James
    • Dr. Mo
    • Dr. Bouwer
    • Dr. Simon Abbey
    • Dr. Aminder Verraich
    • Dr. Nathan Lee
  • Our Office
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  • About Us
    • Dr. Tassos Irinakis
    • Dr. Eleni Irinakis
    • Dr. James
    • Dr. Mo
    • Dr. Bouwer
    • Dr. Simon Abbey
    • Dr. Aminder Verraich
    • Dr. Nathan Lee
  • Our Office
  • Procedures
  • Contact Us
Referring Dentists Forms

Referring Dentists Forms

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Download PDF Form Dr. Nathan Lee

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  • PERSONAL INFORMATION:

  • REFERRING DOCTOR

  • PERIODONTICS

  • Please include all recent radiographs and charting with referral.
  • Max. file size: 256 MB.
  • Max. file size: 256 MB.
  • Max. file size: 256 MB.
  • Max. file size: 256 MB.
  • Max. file size: 256 MB.
  • PROSTHODONTICS

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  • ENDODONTICS

  • Please include all recent radiographs and charting with referral.
  • Please include all recent radiographs and charting with referral.
  • Please include all recent radiographs and charting with referral.
  • Max. file size: 256 MB.
  • Max. file size: 256 MB.
  • Max. file size: 256 MB.
  • Max. file size: 256 MB.
  • Max. file size: 256 MB.
  • ORAL MEDICINE & PATHOLOGY

  • Max. file size: 256 MB.
  • Max. file size: 256 MB.
  • Max. file size: 256 MB.
  • Max. file size: 256 MB.
  • Max. file size: 256 MB.
  • Max. file size: 256 MB.
  • INSURANCE

  • Max. file size: 256 MB.
  • Max. file size: 256 MB.
  • About Us
    • Dr. Tassos Irinakis
    • Dr. Eleni Irinakis
    • Dr. James
    • Dr. Mo
    • Dr. Bouwer
    • Dr. Simon Abbey
    • Dr. Aminder Verraich
    • Dr. Nathan Lee
  • Our Office
  • Procedures
  • Contact Us
Menu
  • About Us
    • Dr. Tassos Irinakis
    • Dr. Eleni Irinakis
    • Dr. James
    • Dr. Mo
    • Dr. Bouwer
    • Dr. Simon Abbey
    • Dr. Aminder Verraich
    • Dr. Nathan Lee
  • Our Office
  • Procedures
  • Contact Us

101 – 1621 Dufferin Crescent
Nanaimo, BC V9S 5T4