RAYNHAM (508) 880-5891
NANTUCKET (508) 228-1085
DARTMOUTH (508) 990-3000
LAKEVILLE (774) 409-2500
MANSFIELD (508) 339-5500

Patient Referral Program

Your referrals are the greatest compliment our office receives!

Immediate family members enjoy a 5% discount off of any treatment and the number of immediate family discounts is unlimited. Discounts apply when treatment begins. When Southeast Orthodontics’ patients or their parents refer a new patient to the practice outside their immediate family they receive:

Patients:
250 reward points if the patient keeps their new patient exam appointment
OR
1000 reward points if the patient starts a treatment within 30 days

Parents:
$25 debit gift card if the patient keeps their new patient exam appointment
OR
$100 debit gift card if the patient starts a treatment within 30 days

Reward points and debit gift cards will be awarded each month for prior month activity. Reward points expire one year after referring patient treatment is complete and debit gift cards one year from issue.


Patient Referral Form

Please fill out the information below, and one of our team members will contact your patient to schedule an appointment time.

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