1025 Lake Shore Blvd E, Unit 4, Toronto, ON

Free Covered Parking On Site

(647) 793-7093

smile@lkdc.org

We speak English, Farsi, Spanish, Mandarin and Cantonese

(Free Covered Parking On Site)

Refer a Patient

We Appreciate Your Trust & Confidence in Our Care!

Patient Referral Form

Submit your referral quickly and securely. We’ll take great care of your young patient.

Patient's Name

Patient's Email

Patient’s Date of Birth

Patient's Phone

Referring Clinic Name

Referring Dentist

Referring Clinic Address

Would you like us to refer back?

Reason for Referral

Thank you for submitting your patient referral. Our team will review the information and follow up as soon as possible.

Please note, if this is a dental emergency, it would be best to call our practice as this is the fastest way to reach us (647) 793-7093.

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At Leslieville Kids Dental Centre, our philosophy is to care for every child as if they were our own.

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