(303) 427-6300

Douglas County Orthodontics

9227 E. Lincoln Avenue, Suite 100
Lone Tree, Colorado 80124

562 Castle Pines Parkway, Suite C-8
Castle Rock, Colorado 80108

Refer a Friend/Family Program

Honor us with a Referral.

A successful orthodontic practice does not just happen. It is the result of a strong commitment to excellence in orthodontics and in our relationships with you, our patients. We would like to thank you for showing your confidence in our practice by recommending us to your friends, family and colleagues at work. We are gratified to find how many new patients regularly call on us based on words of advice and recommendations from our existing and past patients.

Not only do we want to express our truly humble heartfelt Thank You for any new patient that you have been directly responsible for introducing to our office.

We would like to Reward you!

Refer anyone who schedules and is evaluated by Dr. Hamersky: We would gratefully thank you with your choice of:

  • Two Movie tickets ($15 value)
  • $25 credit to your existing account with any balance with us

Refer anyone who schedules and evaluation and begins treatment as recommended by Dr. Hamersky: We would gratefully thank you with your choice of:

  • A voucher for a FREE retainer (value up to $250 depending on type). This voucher can be used by anyone so it must be in your possession. Fully transferrable.
  • $100 credit to your existing account with any balance with us.

 

Patient Referral Form

If you are a patient of record who has referred a new patient to us, please let us know by filling out and submitting the following form.