Guide for Physicians Referring to the Dental Oncology & Maxillofacial Prosthetics Clinic

Currently, our clinic prioritizes the care of patients of the University Health Network and those undergoing current oncologic management within these facilities. When clinic space allows, acceptance of patients from outside centres will be considered.

​​​Urgent Referral

If your patient needs immediate, urgent care:

1
Complete the referral form.
2
Call Marijun Lopez-Sursona at 416 946 2198 for further information.

Please remember that patients must be truly urgent from a medical perspective for them to be seen.​

Please note: Few patients qualify for urgent referrals and all referrals need to complete a dental referral form.

Referral Forms

Standard Referral

To complete the standard referral process:

1
Download and complete the Dental Oncology & Maxillofacial Prosthetics Clinic Referral Form.
2
Include the following information:
  • Patient diagnosis/clinical notes
  • List of patient's medications
3
Fax the completed form to 416 946 6576. Some physicians' offices will send you a confirmation of receipt. The form will be reviewed to ensure that it is complete; if incomplete, or if the form contains initials, acronyms or illegible writing, the form will be returned to you.
4
Our office will call you promptly once the referral form is reviewed for appropriateness for care at UHN. The unit coordinator will contact you with information about the patient's first appointment and in cases where care would best be sought in the community.
Referral Forms

Checklist for a Complete Referral

To ensure your referral is complete, make sure to include:

  • A referral form, filled out in its entirety
  • Patient diagnosis/clinical notes
  • List of patient's medications

Go to the Dental Oncology, Ocular & Maxillofacial Prosthetics Clinic ​​​
https://www.uhn.ca/PrincessMargaret/Health_Professionals/Patient_Referral/Pages/dr_referral_psychosocial_oncology.aspx
https://www.uhn.ca/PrincessMargaret/Education/Continuing_Education_Programs/Pages/continuing_education_programs.aspx
Last reviewed: 10/26/2022
Last modified: 12/4/2023 7:07 AM
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