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Patient Referral

We appreciate the confidence you have placed in us. We guarantee your patient will be treated like a VIP; it all starts with a free orthodontic consultation.

For Orthodontists

If you are referring a patient to us who is already in treatment, please fill out the AAO transfer form in either PDF or Microsoft Word and email/fax to us.

For Family Dentists

Simply fill out the online form below, click submit and we take care of the rest!

* Fields are required.

Online Referral Form:

Patient is being referred for: