Patient Information &
Health History Form

Refer A Friend

  

The greatest compliment Levin Orthodontics can receive is the confidence our patients display by recommending our practice to others. As a token of our appreciation we have established the Refer-A-Friend program. The program consists of the following guidelines:

  1. A patient, past or present, refers a potential patient to our practice.
  2. The potential patient attends the complimentary initial consultation appointment.
  3. At the initial consultation appointment the new patient identifies, in writing, the referring individual.
  4. When the new patient proceeds with full orthodontic treatment a gift of $50.00 will be sent to referring individual.
  5. It is always a pleasure to welcome new patients to our practice!