New Patient Referral Form - Wu Orthodontics

Refer a patient to Wu Orthodontics

If you are a current or past patient of Wu Orthodontics and wish to refer a family member or friend, we have made it easy to do so.

Simply fill out the below form with your details, alongside the details of the person you wish to refer, and we’ll get in contact with them shortly.

"*" indicates required fields

Patient's Details

Name*

First Last

Email*

Phone*

Address

Street Address City State ZIP Code

New Patient's Details

Name*

First Last

Email*

Phone*

Date of Birth*

Parent or Guardian Name

First Last

Address

Street Address City State ZIP Code

Reason for referral*

By submitting this form, you are agreeing to our privacy policy.

What Our Patients Are Saying

More Reviews

I'm so happy with my new smile! Dr Wu Orthodontist and their team were truly dedicated to achieving the best possible results. From the initial consultation to the final day, the entire experience was positive. The orthodontist and staff were always attentive to my needs and concerns.

Flowerroadbbvip Tueme

My daughter just finished her treatment and the result is just perfect. I was Dr. Wu’s patient long time and am still very happy with my result after many years. That’s why I brought my daughter here when she was ready for the orthodontist treatment. Dr. Wu and his staff are always nice and accommodating. They always explain everything clearly and make sure you understand the purpose of each step, which I like a lot. They are also very accommodating for emergency treatment if the bracket is broken or fall off.

Miao Zhang

Wu Orthodontics Is Conveniently Located In Palo Alto CA

Dr. Eric Wu and his team provide quality orthodontic care with Pitts21 Bracket System and Invisalign^® for patients of all ages in the Palo Alto area including Los Altos, Menlo Park, Stanford, Atherton, Mountain View, Woodside, and Redwood City California. Contact our office for your initial “Smile Evaluation” consultation.