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Refer Your Patients to 
Sheffield & Le Orthodontics!

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At Sheffield and Le Orthodontics, we love partnering with dental professionals to ensure that your patients have a seamless and rewarding experience while receiving dental care and orthodontic treatment.

If you have a patient in need of orthodontic treatment, please complete our referral form on this page.

Creating beautiful smiles is a team effort, and we are eager to collaborate with your dental practice to bring healthier, happier smiles to everyone in our community. Together, we can make a lasting impact on patients’ lives.

Please fill out the form below or download the .pdf here. Once you’ve filled out the .pdf, please email it to us at [email protected] and provide the patient a copy to bring in during their appointment.

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Patient Information

Patient Name*
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Referral Information

Responsibile Party's Name*
Consent*