Dentist referral

Name: OrthodontiX
Telephone: 0800 678 463

At OrthodontiX, we love working with dentists to ensure that the health of our patients’ smiles are in top form. If you would like to refer your dental patients for treatment at our practice, please fill out our referral form below:

Dentist's details

Field marked with * is required.

Dentist Name*

Practice Name

Phone*

Email*

Patient details

First Name*

Last Name*

DOB*

Parent or Guardian Name*

Contact Email*

Contact Phone*

Address

Attach any patient X-rays, images, and reference material files here:

Select File

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Visit us

Please select the location nearest you from the dropdown list below. We are reachable by phone from 8:00 AM to 5:00 PM, Monday to Friday, for both locations.

Cashmere

36 Colombo Street,
Cashmere
Christchurch 8022

0800 678 463

Opening Hours

Mon: Closed
Tues - Thurs: 8:00am - 5:00pm
Fri - Sun: Closed

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Ashburton

1A Queens Drive,
Allenton
Ashburton 7700

0800 678 463

Opening Hours

Mon - Thurs: Closed
Fri: 8:00am - 5:00pm
Sat - Sun: Closed

Open in Google Maps