Close

Dentist Referral

Referring your patients to Dr. Angela Waciuk is easy.

You can use our simple on-line referral form below that sends your patient’s information directly to us using secure, PHIPA compliant privacy protection.

Or you can download a printable PDF version of the referral form by clicking the download button below.

We will then contact the patient directly to arrange an appointment.

Download .PDF form


Referral Form

  • MM / DD / YYYY
  • Drop files here or
    Accepted file types: jpg, gif, jpeg, png, pdf, zip.
    (8mb maximum; file types allowed: jpg, gif, png, pdf, zip)

Frequently Asked

Questions

Why do I need to see a Periodontist?

Most commonly your dentist has referred you to a Periodontist to evaluate a concern associated with the foundation for your teeth, such as bone and gum tissue. This may be a small area or incorporate many teeth.

Will my appointment be covered by my insurance company?

Insurance coverage is dependent on your contract with your insurance company. We will provide estimates to your insurance company on your behalf to help determine if any treatment we recommend is covered. Learn more.

What are my payment options?

We will strive to make the financial portion of your visit as easy as possible. We are a fee for service practice accepting a variety of payment options. Learn more.

If I need gum surgery will it hurt?

Gum surgery will typically come with some discomfort that lasts anywhere from 1 to 3 days post treatment. If pain medications are taken as prescribed, the discomfort can often be eliminated and patients are very comfortable.

Will I need to take time off work?

Time off is not often recommended but if it is needed, it will be discussed at the time of consultation. Doctors notes can be provided if necessary.

If I am having surgery, do I need someone to drive me home?

A responsible driver is only needed if you are having sedation along with the surgery. For any local anesthesia, a driver is not necessary.

Can I eat before I come to my surgery?

Eating is NOT permitted 6 to 8 hours before surgery IF you are having treatment with IV sedation only. A light meal 2 to 3 hours before is allowed for oral and Nitrous oxide. With local anesthesia you can eat normally.

If I see a Periodontist for cleaning, do I still need to see my regular dentist?

Yes. We encourage all of our patients to continue to see their dentist for regular check ups for decay and other tooth related dental concerns. Cleanings are also often shared so we provide cleanings on an alternating basis.

I think I need to see a Periodontist, what should I do? Should I see my dentist first?

If you are concerned with issues related to bleeding, recession, mobility or other periodontal problems, speak with your dentist and ask for a referral. Most dentists will gladly make a recommendation to a specialist.