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Patient Referral Program

Patient-Referral-ProgramYour referrals are the greatest compliment our office receives!

We strive to exceed your expectations, and if we’ve succeeded, we hope you’ll let your friends and family know about our practice.

When you refer a friend or non-immediate family member for an initial exam you will receive one of the following:

$25 added to your rewards card when the patient attends their new patient exam appointment

$25 added to your friend’s rewards card when they begin treatment

$25 AMEX Gift Card if the referring patient is no longer in active treatment

Rewards will be awarded each month for prior month activity. Reward points expire one year after referring patient treatment is complete and gift cards one year from issue.


Patient Referral Form

Please fill out the information below, and one of our team members will contact your patient to schedule an appointment time.

Refer a Friend


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Southeast Orthodontics

  • Raynham - 302 Broadway, Rt. 138, Suite 6, Raynham, MA 02767 Phone: 508-880-5891
  • Nantucket - 19 ½ Surfside Road, Nantucket, MA 02554 Phone: 508-880-5891
  • Mansfield: - 100 Copeland Dr. Suite 9, Mansfield, MA 02048 Phone: 508-339-5500
  • Lakeville - 40 Main Street, Lakeville, MA 02347 Phone: 508-880-5891
  • Dartmouth - 408 State Road Route 6 Suite 730, Dartmouth, MA 02747 Phone: 508-880-5891

Five Convenient Locations

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