Patient referral form
Please complete the fields below. We will follow up directly with the patient to schedule a complimentary exam.
Referral details
Why refer to Payne Orthodontics
Hygiene Educational Program
We partner with Oral B and use the Ortho Essentials Hygiene Program. Younger patients receive a new Oral B 5000 electric toothbrush the day braces are placed.
Flexible Scheduling
Complimentary initial examinations for all children and adults, with before-school, after-school and lunchtime availability across Santa Rosa and Windsor.
Family Care Program
Complimentary orthodontic screenings recommended at age 7, with observation monitoring and screening panorex offered to young patients at no charge.
On-site Insurance Specialist
We research individual benefits and file claims, with flexible payment options including CareCredit. Invisalign Preferred Provider.
In-House Cone Beam CT
3D imaging for precise diagnosis and treatment planning using state of the art CBCT technology and digital imaging.
iTero Scanner
Impression-free digital scanning with digital simulated outcomes. No goop, no gagging.