for referring practitioners

Refer a patient,
in under two minutes.

Complete the short form below and send it straight to our specialist team, it takes about two minutes. We reply within 1 to 2 business days and use the details only to arrange your patient's care.

SpecialistRegistered specialist orthodontist, four university degrees

DCNZ + GDCDual-registered, New Zealand & United Kingdom

PublishedPeer-reviewed orthodontic research

2 locationsNewmarket & Albany, North Shore

online referral

Your referral, step by step

Three short sections, then one click to send your referral to us. Radiographs and scans can be emailed separately from your practice software.

1 · Referring practitioner

Practice name *

Referring clinician *

Role

Practice phone *

Practice email *

2 · Patient details

Patient full name *

Date of birth *

Patient / caregiver phone *

Patient / caregiver email

Parent or guardian name (if the patient is under 18)

3 · Clinical information

Primary reason for referral *

Urgency

Preferred clinic

How will records reach us?

Records available

OPG / panoramic Lateral cephalogram Clinical photographs Intraoral scan / models

Clinical notes, relevant history and specific requests

The patient (or their parent/guardian) is aware of and consents to this referral and to their information being shared with Milk Orthodontics for that purpose. *

When you click send, your referral goes straight to our specialist team and we reply within 1 to 2 business days. Please email any radiographs or scans to us separately from your practice software. Prefer to talk first? Call us on (09) 520 1880.

thank you for your trust

Your patient is in specialist hands

You'll receive written confirmation when we see your patient, our findings and plan, and a completion report when they return to your care.

Questions? Call (09) 520 1880

Refer a patient,
in under two minutes.

Your referral, step by step

Thank you, we have your referral

Your patient is in specialist hands

Contact us