Doctor Referral

Thank you for showing your confidence in our practice by recommending us to your patients. Please fill out the referral form below.

A successful practice doesn’t just happen. It is the result of a strong commitment to excellence in our treatment and in our relationships with patients and other doctors. We’d like to take a moment to thank you for showing your confidence in our practice by recommending us to your patients. We’re gratified to learn that many new patients call us based on your words of advice!

Please Select Office and Preferred Doctor (Select One Only)

Mission Creek Orthodontics
Kelowna Orthodontics
West Kelowna Orthodontics

Please fill out the following information about your patient

Patient Name(Required)
MM slash DD slash YYYY
Is there any dental work outstanding?
Have any panoramic or cephalometric radiographs been taken in the past 3 years? (If yes, please forward to our office and indicate the date they were taken)
Please call dentist BEFORE / AFTER examination
MM slash DD slash YYYY
We'll send you a copy of this referral form.

Why Choose Our Practice

Patient First Approach

We put your needs first to achieve efficient and comprehensive treatment in a supportive and nurturing environment.

Welcoming Team

We know that our office is only as effective and as welcoming as the people who work in it, which is why we take pride in our friendly and well-trained team members.

Interest Free Payments

We understand that orthodontic treatment can be a big investment. To help fit it into your specific budget, we are happy to offer zero-interest payment arrangements.

Our Satisfied Patients

We love hearing from our patients! Thank you to everyone who has taken the time to provide us with feedback. It means the world to us!