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Doctor Referral

Online Referral Form

You may refer patients to our office by filling out our secure online Referral Form. After you have completed the form, please make sure to press the Complete and Send button at the bottom to automatically send us your information. The security and privacy of patient data is one of our primary concerns and we have taken every precaution to protect it.

Online Referral Form for Burlingame orthodontist Dr. April Lee

TEXT OUR OFFICE

Text message is limited to 160 characters.

HOW IT WORKS

  1. Enter your Name.
  2. Enter your Cell Phone Number, area code first
  3. Enter your text message in the box.
  4. Click "Send Text"
  5. A copy of this text will be sent to the office and to your cell phone. The office's reply will also be sent to your cell phone where you can continue the text conversation.
Note: Mobile message and data rates from your cell phone carrier may apply.Close ClickToCall Button
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