Recommend Us to Friends and Family

Refer a Patient to Dr. Kwon Pediatric Dentistry

Referring a patient to Dr. Kwon Pediatric Dentistry reflects the trust and confidence our community has in our services. We take that trust seriously and strive to provide the best possible care to everyone we welcome through our doors.

We’re proud to work with other local healthcare providers and community resources to connect families with pediatric dental care in Northeast Georgia. We also accept referrals of friends and family members of our current patients. If you would like to refer a patient to our office, please fill out the form below or contact our office to provide the information we need to get an appointment scheduled.

If you would like to make a referral for orthodontic treatment, please contact our partners at Kwon Orthodontics.

Need Your Back-to-School Form 3300 Completed?

Students enrolling in Georgia public schools for the first time will need to have a vision, hearing, dental, and nutrition screening completed before heading to class. To do this, you’ll need to have Form 3300 signed by the screener, and we can take care of your child’s dental health screening before their exciting first day. Let us know if you need Form 3300 filled out and signed, and we’ll take care of it!

Referring a Patient for Pediatric Dentistry

"*" indicates required fields

Patient’s Name*

First Last

Patient’s Date of Birth*

Name of Parent or Legal Guardian

Patient or Guardian’s Phone Number*

Patient or Guardian’s Email Address*

Preferred Location*

Referring Doctor or Provider (if applicable)

Referring Office Name

Referring Doctor or Provider’s Phone Number

Comments*

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