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Contact Us | Patients Referral Form | Orthodontists serving Kelowna, BC (British Columbia), Iain Allan and Bill Mulgrew

Orthodontists
Dr. Iain Allan and
Dr. Bill Mulgrew
Orchard Plaza Professional Building
1890 Cooper Rd. | Suite 315
Kelowna, BC V1Y 8B7
TEL: 250-860-3111
FAX: 250-860-3124

Patient's Referral Form

If you are a patient of record who has referred a new patient to us, please let us know by filling out and submitting the following form.

Today's Date:
Your Name:
Your Telephone:
Your Email Address:
Full Name of the Patient You Are Referring:
Comments:
Verification Code
(case sensitive):