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Professional Referrals

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We appreciate your referral our BC periodontists for periodontal care. Once your referral is received, we will follow up with you to confirm next steps with your patient.

Complete the online form below or click to download a PDF.

Form for Dr. Nematollahi (Burnaby)  Form for Dr. Yang (Langley)

All information is held in the strictest privacy. 

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Periodontal Care in North Burnaby & Langley

Contact Proactive Periodontics for a consultation and treatment planning appointment with Dr. Mandana (Mandy) Nematollahi or Dr. Yi Yang.

Professional dental referrals and self-referrals are warmly welcomed. 

Book Appointment   Refer Patient

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