Referral Program

New Patient Gift Certificate

You and your friend will receive a gift of $100 credit towards dental treatments.*

Sharing smiles is our passion! Introducing our Care to Share program for our valued patients who want to spread the word about our exceptional dental care.

Please fill out this quick form and we’ll send your friend their Care to Share confirmation right away! We’ll also send you a confirmation of your $100 credit by email.

Your Name(Required)

Your First Name Your Last Name

Your Email(Required)

Friends Name(Required)

Friend's First Name Friend's Last Name

Friend's Email(Required)

Tell your friend here about the Care to Share email they're about to receive.(Required)

* Not to be used for cash, transfer to others, existing account balances, orthodontic treatments, or in conjunction with other promotional offers.