Refer a patient to our practice
Please use the form below to refer a patient or download our online form, and email or fax it to us. For your convenience, brightsmiles Pediatric Dentistry can provide your office with referral pads. Just call (773) 423-6050 or email us at firstname.lastname@example.org and we will be happy to drop off a referral pad.
We welcome referrals from Chicago and surrounding suburbs. brightsmiles Pediatric Dentistry has special fast-track emergency appointments available for your referral patients and we will do our very best to provide your patients with excellent and very timely pediatric dental care.
Thank you very much!