Refer Your Patients to Lake Minnetonka Orthodontics!

At Lake Minnetonka Orthodontics we enjoy collaborating with dental professionals to keep patients happy and their smiles healthy. If you’re looking to refer a patient for orthodontic treatment, please fill out our form on this page.

It takes a collective effort to give our patients reasons to smile, and we’re excited to work closely with your dental practice to create more happy, healthy smiles for everyone in our community.

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Patient Name*

Guardian Name

Age

Phone*

Which office do you prefer?*

Do you have a Panoramic X-Ray?

Yes

Date of Last Panoramic X-ray

Preferred Appointment Date

Referred By

What can we help you with?*

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