Referral Form

You may refer patients to our office by filling out our secure online Referral Form. After you have completed the form, please make sure to press the Submit button at the bottom to automatically send us your information. The security and privacy of patient data is one of our primary concerns and we have taken every precaution to protect it.

Dr. Melo

Online oral surgery referral form

Dr. Saini

We appreciate your referrals and will do our best to schedule your patients in a timely manner.

Please click the link below to download our Referral Form which can be faxed to the office at 250-727-3301 or emailed to reception@victoriaoralsurgery.com.