Referrals

The first step toward achieving a beautiful, healthy smile is to schedule an appointment.

A successful practice doesn’t just happen; it is the result of a strong commitment to excellence in the professional community and in the relationships we build with our patients and colleagues. We appreciate the confidence you’ve placed in us to provide your patients with the complete care they need, and we thank you for recommending our practice to your patients.
If you are here to refer a patient to our practice, please provide us with the information below. Once you’ve completed the form, click on the SUBMIT button at the bottom of the page.

If you would like a physical copy to provide to your patient, please download and print our form.

Download form

Contact Information

Referral information

Radiographs Sent?

Your smile is yours forever, and we want to make it as easy as possible for you to receive the best orthodontic care whenever you need it.

Call us now

Schedule your consultation

Contact our Green Bay or De Pere, WI orthodontic office and schedule a consultation today. The sooner you call, the sooner you’ll be on the path to the smile of your dreams!

Get in touch