If you are a dental or orthodontic professional who wishes to refer a patient to see our orthodontist in San Jose or Almaden Valley, California, we invite you to fill out a referral form! You can submit your referral request to Phan Orthodontics online or you can download and print the form to give to us. If you have any questions, please call 408.251.7901 to speak with a member of our team. Dr. Derick Phan is looking forward to meeting and working with your referred patient!
Online
Referral Form
Referral Form
Downloadable/PDF
Referral Form
Referral Form