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Dr Marguerite Paterson

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Specialist Orthodontist

Dentist Referral

clinical referral

CLINICIAN REFERRAL

We’d love to hear from you – please fill out the form below.

Location

55 Crawford Street,

Dunedin,

9016

+64 21 244 9212

info@patersonortho.co.nz

Clinician information

Referring Clinician

Email

Patient information

Patient name

Parent name (if child under 18yrs)

Patient date of birth

Contact number

Patient Email

Reason for referral *

Crowding

Spacing

Increased overjet

Reverse overjet

Deep bite

Open bite

Crossbite(s)

Space maintenance

Oral habits

Impacted teeth

Dental wear

Hypomineralised teeth

Other

Has this patient had a dental check up in the last 6 months?

Yes

No

Additional information

Thank you for contacting Paterson Orthodontics. A member of our team will in touch!

Contact Us

PATERSON ORTHODONTICS Ltd

Opening Hours

55 Crawford Street,

Dunedin, 9016

021 244 9212

info@patersonortho.co.nz

Tuesday 9.00am - 5.00pm (reception only)

Wednesday 9.00am - 5.00pm (reception only)

Thursday 8.30am - 5.00pm

Friday 8.30am - 5.00pm

Copyright © 2022 Paterson Orthodontics Ltd. All rights reserved

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