The Standard YourPatients Deserve.

Doctor Referral.

Thank you for trusting Vivid Orthodontics with your patients. We look forward to collaborating with you. Please complete the form below or call our office to get started.

Partners in Patient Care.

Thank you for trusting Vivid Orthodontics with your patients’ smiles and long-term health.

Whether your patient is a child needing early growth guidance, a teen ready for clear aligners, or an adult seeking airway solutions, we are committed to a seamless collaboration. We view every referral as an extension of the quality care you’ve already started. We take your trust seriously and are dedicated to delivering expert results with the personal touch your patients deserve.

Refer by Phone.

Select a location below to call us directly.

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Refer by Email.

Referring Practice Information

Doctor Name (First and Last)

Practice Name

Practice Phone

Vivid Orthodontics Location

Select Location

Referral Information

Name

First

Last

Patient Date of Birth

Is the patient a child?

Patient or Guardian Phone Number

Patient or Guardian Email Address

Primary Insurance Information

Does the Patient Have Insurance Coverage?

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Additional Notes/Details

Company/Carrier Practice Name

Signature

Clear Signature

The Standard YourPatients Deserve.

Doctor Referral.

Thank you for trusting Vivid Orthodontics with your patients. We look forward to collaborating with you. Please complete the form below or call our office to get started.

Partners in Patient Care.

Thank you for trusting Vivid Orthodontics with your patients’ smiles and long-term health.

Refer by Phone.

ALL LOCATIONS

Refer by Email.

Referring Practice Information

Vivid Orthodontics Location

Referral Information

Primary Insurance Information

Secondary Insurance Information (If Applicable)

Our Locations

— McKenzie Towne SE

— Aspen SW

— Westwinds NE

— Okotoks