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Refer your patients in seconds using our streamlined digital referral form,

and we'll take it from there.

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Simply click the "Send a Referral" button below to complete our fully HIPAA-compliant, secure pop-up form via SimplePractice using these steps:
 

• "Your Info": Please enter your professional contact details (name, phone, and email).
   

• "Client’s Info": Provide the patient’s name, DOB, phone number, and state.
   

• Under "Client Preferences," "Is there anything the practitioner needs to know?”, please include the reason(s) for the referral (e.g., speech delay, difficulty saying R sounds, lisp, tongue thrust swallow, anterior open bite, tongue tie).