Refer a

Patient

Please fill out the form below to refer a patient to our office. Our team will contact you or the patient’s family during clinic hours, typically within 2 business days.

Medical history:*
X-rays — include any intraoral X-rays or PAN taken*
X-rays — include any intraoral X-rays or PAN taken*
Patient’s dental insurance*
Patient’s dental insurance*

Office Hours

Monday to Thursday — 8:30am to 4:30pm

Friday — 8:30am to 4:00pm

Saturday & Sunday — closed

Proudly Serving

Bolton, Nobleton, Schomberg, Orangeville, King, Shelburne, Caledon, King City, New Tecumseth, Tottenham, Alliston, Maple, Woodbridge, Vaughan, Kleinburg, King City, Richmond Hill, Bolton, Bradford, Brampton, Mississauga, Georgetown, Aurora and the Greater Toronto Area

© Copyright 2026 | Bolton Kids Dental

Office Hours

Monday to Thursday — 8:30am to 4:30pm

Friday — 8:30am to 4:00pm

Saturday & Sunday — closed

Proudly Serving

Bolton, Nobleton, Schomberg, Orangeville, King, Shelburne, Caledon, King City, New Tecumseth, Tottenham, Alliston, Maple, Woodbridge, Vaughan, Kleinburg, King City, Richmond Hill, Bolton, Bradford, Brampton, Mississauga, Georgetown, Aurora and the Greater Toronto Area

© Copyright 2026 | Bolton Kids Dental

Office Hours

Monday to Thursday — 8:30am to 4:30pm

Friday — 8:30am to 4:00pm

Saturday & Sunday — closed

Proudly Serving

Bolton, Nobleton, Schomberg, Orangeville, King, Shelburne, Caledon, King City, New Tecumseth, Alliston, Maple, Woodbridge, Vaughan, Kleinburg, King City, Richmond Hill, Bolton, Bradford, Brampton, Mississauga, Georgetown,
Aurora and the Greater Toronto Area

© Copyright 2026 | Bolton Kids Dental