No Referral Required

Referring Doctors

Referral Forms

Thank you for your kind referral as your preferred periodontal clinic in Melbourne. We look forward to working with you to promote the oral health of our mutual patients. Please advise your patients that the initial appointment at Melbourne Periocare would involve an in-depth examination and consultation only and the treatment would usually commence at a separate appointment.

For your convenience we have provided a printable PDF referral form (see below) for referral submissions.

Download the Referral Form

Click below to download the Referral Form

Alternatively fill in the following online form