Doctor Referral Portal
Refer your patient directly to Dr. David D’Aloisio or Dr. Henry Assad. Choose the appropriate orthodontist below and submit the referral online, or download a printable paper referral form.
- Secure online referral forms
- Printable PDF referral forms
- Upload supporting records
- Referral support available
Choose Your Doctor
Select Dr. D’Aloisio or Dr. Henry.
Select a Format
Refer online or download the PDF.
Include Records
Attach relevant clinical information.
Submit Securely
Send the completed referral to our team.
Who would you like to refer your patient to?
Each orthodontist has a dedicated online referral portal and printable paper referral form.
Sudbury Orthodontics
Dr. David D’Aloisio
OrthodontistSubmit a secure digital referral directly to Dr. D’Aloisio, or download and complete his printable referral form.
Sudbury Orthodontics
Dr. Henry Assad
OrthodontistSubmit a secure digital referral directly to Dr. Henry, or download and complete his printable referral form.
A simple process for your dental office
Choose the orthodontist, select your preferred referral method and include the clinical information needed for coordinated patient care.
Select the Orthodontist
Choose Dr. David D’Aloisio or Dr. Henry Assad based on your preferred referral destination.
Choose Online or Paper
Submit the referral digitally, or download the corresponding PDF to complete and send separately.
Include Clinical Records
Provide the reason for referral and attach available radiographs, photographs or supporting records.
Need assistance with a referral?
Our team is available to help with online portal questions, PDF referral forms, record submission and patient scheduling.
Thank you for your referral
We appreciate the confidence you place in Sudbury Orthodontics and look forward to collaborating with your office in the care of your patient.
250 Notre Dame Ave, Sudbury, ON P3C 5K5 · 705-671-6261