Free Dental Referral Form Template

Access a free Dental Referral Form Template and streamline your referral process. Download the PDF and example now.

By Ericka Pingol on Jul 15, 2024.


Fact Checked by Ericka Pingol.

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Free Dental Referral Form Template PDF Example
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Understanding dental referrals

Dental referrals are essential to the patient's journey towards optimal oral health. A referral is a process where a primary care dentist evaluates a patient's dental needs and then determines whether to refer them to a specialist for further diagnosis, treatment, or management.

The Canadian Dental Association recommends that all dentists have a standardized referral form to ensure efficient and effective communication with other dental professionals. This form should include the patient's medical history, specific medical problems relevant to their dental care, and contact details.

A dental referral form template is a standardized document that simplifies referring patients between dental professionals. They guide dentists to gather the necessary information for a smooth referral process. These forms are available in various formats, including printable dental referral forms and editable digital versions.

Free Dental Referral Form Template

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Free Dental Referral Form Template Example

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Why use a dental referral form?

Dental referrals are essential because they help ensure that patients receive timely and appropriate treatment for their dental conditions. Here are some of the benefits of using this form:

Clear communication

A referral form provides essential information about the patient's condition, making it easier for the receiving dental professional to understand their needs and provide appropriate care. This eliminates any miscommunication or confusion that may occur during a verbal referral.

Efficient process

With a standardized form, dentists can easily collect and transfer all necessary information in one go, saving time and effort.

Complete information

A referral form prompts dentists to gather all relevant medical information, ensuring the receiving dental professional understands the patient's condition and needs.

Legal protection

In case of legal disputes, a dental referral form acts as a record of the patient's condition and the transfer of care. It helps protect both the referring and receiving dentists.

How to use Carepatron's free Dental Referral Form Template

Our free Dental Referral Form is easy to use and fully digital. Here's how to get started:

Step 1: Access the template

Download the referral form using this page's link or the Carepatron app. You can also get a copy from our resources library.

Step 2: Use the digital format or print a copy

You can either use the digital version of our form or print a hard copy. We recommend using the digital format for its convenience and ease of use.

Step 3: Complete the form with the patient's information

Fill in all necessary fields on the form, including referral and contact details. Be specific and include any medical history or problems relevant to the referral.

Step 4: Submit the form

Once completed, submit the form electronically or via mail to the receiving dental professional. The digital format allows for easy submission with just a few clicks.

Who is this dental referral form for?

Our free Dental Referral Form Template is designed for dental professionals needing to refer patients to other dental clinics. This includes the following professionals:

  • Dentists
  • Dental hygienists
  • Orthodontists
  • Oral surgeons
  • Endodontists
  • Periodontists
  • Prosthodontists

Benefits of using Carepatron free dental referral form PDF

Here are some of the benefits of using our free Dental Referral Form Template:


Our Dental Referral Form Template is simple and designed to be easily understood by all dental professionals. The spaces allotted for specific patient data, treatment details, and the referring dentist's notes ensure that all critical information is relayed to the receiver.

Customizable and adaptable

This generic dental referral form can be modified and tailored to your clinic's needs. It is available in both digital and printable formats. The blank dental referral form serves as a canvas that you can adjust according to the specific information you wish to relay.

Easy accessibility

The dental referral form PDF is accessible on any device, allowing dental professionals to quickly fill, save, and send the form, regardless of location. This increases efficiency and reduces the time for referrals, providing a better experience for you and the patients.

Other options for dental referrals

Apart from using a dental referral form, another option for efficient referral management is to use an online referral management service. This service allows for the secure and timely transfer of patient information between healthcare providers, reducing the risk of errors and delays in treatment.

A referral management service exists to streamline the referral process, saving time and effort for the referring dentist and the receiving specialist. It also allows for better communication and collaboration between healthcare providers, ultimately improving patient outcomes.

However, forms like a dental referral letter template, dental medical history form, and treatment plan form are available online for easy access and use. Utilizing these forms saves time and ensures that all necessary information is accurately communicated between healthcare providers.

Are the dental referral forms printable?
Are the dental referral forms printable?

Commonly asked questions

Are the dental referral forms printable?

Absolutely. Carepatron's dental referral forms are designed for ease of use and can be printed directly from the platform, offering convenience for dental professionals and patients.

Can I customize this dental referral form template?

You can customize the forms to suit your practice's specific needs. You can add or remove fields according to your preferences, ensuring you capture all relevant information.

Why do you need a standard dental referral form?

This form helps patients get specialized care by providing information about their medical history and specific dental problems. It also serves as a communication tool between healthcare providers, ensuring patients' needs are met efficiently.

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