Refer A Patient

 

Thanks very much for your confidence in Mar Orthodontics. We are grateful for your referrals. 

"Communication with referring dentists is important to me. It creates a seamless continum of care and helps patients feel comfortable and looked after. It also helps provide individualized treatment." - Dr. Ly T. Mar

Our Referral Program includes:

  • An initial consultation with Dr. Mar (via phone) to discuss your patient's needs (as requested). 
  • A progress report from Dr. Mar (via phone) within the first six months of treatment. 
  • Accessibility - throughout treatment Dr. Mar is available to the referring dentist anytime by phone. 

Patient Referral Form

Please fill in this form and a member of the Mar Orthodontics Team will contact your patient to schedule a consultation. Dr. Mar will follow-up with the referring dentist directly. Thank you.  

 

  • Referring Dentist Information

  • Would you like an initial phone consultation with Dr. Mar?

  • Patient Information

  • Should be Empty:
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