Refer a Friend

Office Location | Refer a Friend | Appointment Request

A successful practice doesn't just happen. It is the result of a strong commitment to excellence in our treatment and in our relationships with patients and doctors. We'd like to take a moment to thank you for showing your confidence in our practice by recommending us to your friends, family, and colleagues. We're gratified to find how many new patients regularly call on us based on your words of advice.

Choose a form:

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.

Your Information:

  • Name:

  • Phone Number:

  • Email Address:

Who Are You Referring?

  • Name:

  • Additional Information:

  • For Security Purposes, Please Enter the Code Below:

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  • My smile is the most important thing I put on each day. Dr. Jordan completed my ortho treatment almost 25 years ago and I couldn't be happier with the results to this day.
  • People are always telling me I have a gorgeous smile, and that I am so lucky. I always tell them all the same thing. I tell them that my Orthodontist, Dr Jordan, is to thank.
  • Thank you so much for my wonderful smile. I get lots of compliments on it. I always say thank you, Dr Jordan, my Orthodontist did a great job!
  • I highly recommend Dr Jordan and his entire super friendly staff to anyone, who may be old or new to the Tacoma area and actively looking for an excellent Orthodontist, and need an honest, true assessment/recommendation.