Call us at

Cornerstone Shopping Centre, #307, 201 Southridge Drive,
Okotoks, Alberta T1S 2E1
General Dentist - Dr. Dustin Wilson D.D.S.

Referring Providers

For Referring Practices Use Only:

Referring practices, please use this form to refer patients requiring tooth extractions, sinus lifts, bone grafting, implant placement, cone beam scan, and other services to Cornerstone Dental Clinic.


Fields with a * indicate required.

Date * (required)

Referring Clinician * (required)

Referring Clinician's Email * (required)

Patient Name * (required)

Date of Birth * (required)

Phone * (required)

Cell-Phone

Reason for Referral

If Other

Tooth Number/Area of Concern

Current Records

Radiographs (within last year)

If Other

Records being sent


How being sent?:

Upload X-Rays (file types allowed, jpg, jpeg, png)

Allowed Filetypes: jpg, jpeg, png

Allowed Filetypes: jpg, jpeg, png

Allowed Filetypes: jpg, jpeg, png

Allowed Filetypes: jpg, jpeg, png

Allowed Filetypes: jpg, jpeg, png

Additional Comments:

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Call Cornerstone Dental at (403) 995-1800 to request your appointment today.
No referral is necessary and new patients are warmly welcomed.