Refer a Patient

Thank you for your confidence in referring patients to myORTHODONTIST. We look forward to collaborating with you - and taking exceptional care of them. Please complete the form below or call our office to get started.

All Referrals Welcome

We know you have a choice when referring your patient to an orthodontist. We thank you for considering myORTHODONTIST.

Whether your patient is a child who can benefit from early intervention, a teen who needs braces or Invisalign or an adult who may be having airway issues or simply wants a straighter smile, our team is committed to continuing the quality of care you've started.

We want you to know that we take the matter of your trust as our responsibility.

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We invite you to check in regularly to read the latest in our educational posts for professionals. 

Refer by Phone

Click on a link below to reach the myORTHODONTIST nearest you.

Referral by Email

Please provide us with as much information as possible. We'll be in touch with your patient or parent/guardian to follow up. Thank you!

Referring Practice Information

Doctor Name (First and Last) *

Practice Name *

Email *

myORTHO Location

Select *

myORTHO Westwinds (North Calgary) myORTHO Mckenzie Towne (SE Calgary)

Referral Information

Patient First Name *

Patient Last Name *

Is the patient a child? *

Yes No

Parent or Guardian Name (If relevant)

Relationship to Child (If relevant)

Parent Grandparent Guardian Other, please provide details in Comments below

Patient or Guardian Phone Number *

Patient or Guardian Email Address

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