Patient Referral

Thank you for choosing Griffin Orthodontics for your patient’s orthodontic care. We value the trust you place in our team and are committed to providing the highest quality treatment in a comfortable, welcoming environment.

How to Refer a Patient:

Please complete the form below with the patient’s information and any relevant clinical notes. Our team will contact the patient directly to schedule a consultation.

Our Commitment to Your Patients:

At Griffin Orthodontics, every patient receives personalized treatment planning, clear communication, and exceptional care using the latest orthodontic technology. We strive to be a trusted extension of your practice and ensure your patients feel confident and cared for at every step.

Referring Dentist *

Referring Dental Office *

Date of Patient's Last Cleaning *

Patient Full Name *

Patient Date of Birth

Reason for Referral *

Submit

Please do not fill in this field.