Refer a Friend

Refer a Friend…get a $100 gift card.

Here’s how it works…

• Refer your friend(s) for a complimentary new patient evaluation.
• Your friend presents the Refer A Friend card at his/her new patient appointment or tells us that they were referred by you.
  • Download Refer A Friend Card [PDF]
• You will receive a $100 gift card when your friend begins comprehensive orthodontic treatment.

**Your referred friends must be a new patient at SMO and begin comprehensive orthodontic treatment before December 31, 2022. Family members are not eligible for the Refer A Friend program.

Please provide us with the information below. Once you've completed the form, click on the SUBMIT button at the bottom of the page.

Referral Information:

Bold Fields are required.

Your Name: First and Last Your Email Address: Name of the Patient You are Referring: First and Last Patient's Phone Number: Patient's Email Address:
Relationship to New Patient: i.e. coworker, friend, etc.

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Submit Referral