Refer A Friend

Enter To Win 5 Tickets to Six Flags!

Here’s how to enter:

  • Think of a friend or family member who can benefit from a beautiful smile for 2022!
  • Tell us who your friend or family member is by entering their information below (Self Referrals Are Allowed)
  • You will receive one entry for each friend or family member that schedules a consultation with us!
  • You will be entered for a chance to WIN when they come for their first appointment! Be sure to have them mention your name.
  • Winner will be chosen on 7/15/22

"*" indicates required fields

Your Friend’s Information

Referred By