🩺 Doctor Referral Portal

Thank you for referring your patients to Smiles For Kids. Please select the appropriate form below.

Refer a Patient

Send a new patient to our office for pediatric dental evaluation, orthodontics, sedation, or other services.

Referral Form

Ortho Treatment Request

Request specific procedures (extractions, surgical exposure, frenectomy) prior to or during orthodontic treatment.

Treatment Request

Questions? Call us at 770-781-0203