Doctor Referral

Patient Referral Form

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Referring Doctor *

Phone

Patient Name *

Referring Doctor *

D.O.B. *

Contact patient to schedule appointment via:

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Cell

Home Phone

Email *

Other

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Notes/Comments

What Our Patients Say

“I received a thorough exam for orthodontia from Dr Race and he found that I did not require treatment. I was impressed with the ethical manner in which he conducts his practice. My son did his corrective treatment with Dr Race and he was very pleased with the outcome.”

Laurie C

“I REALLY WISH I WOULD’VE FOUND THIS PLACE EARLIER!!❤️ All the staffs were very helpful, asked, and answered any questions or concerns I had! MADE ME FEEL VERY VERY COMFORTABLE, so sweet! I can’t wait for my next appointment !”

siworld

“Race Orthodontics is fantasic with both of our daughters! Both girls have unique teeth/mouths and we appreciate the expertise that Race has to offer! The doctors are amazing – the staff is always friendly and we love coming to our appointments!”

Jennifer Ryan

“Dr Kevin and Dr Danielle are amazing, and so is their staff. Very professional atmosphere, without lacking in genuine concern. Always looked forward to my next appointment and the result is unbelievable! I’m just disappointed that I didn’t decide to go sooner!”

Nicole Kafkas

“You guys are awesome!!”

Brody Gahagan

We welcome patients of all ages

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Orthodontic Insights

Coming Soon

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Sleep and focus often start with breathing, especially for growing kids. This post explains how Airway Orthodontics supports healthier nighttime [...]

Choosing the Best Braces Options: A Guide from Your Orthodontist in Brookfield

When you begin your journey toward a healthier smile, the variety of available treatments can feel overwhelming. Selecting the right [...]

Adult Orthodontics in Brookfield and Mukwonago, WI: It’s Never Too Late to Transform Your Smile

Many adults believe that the window for a straighter smile closed once they left their teenage years. However, orthodontic [...]

Doctor Referral

Patient Referral Form

What Our Patients Say

Orthodontic Insights

Coming Soon

How Airway Orthodontics Improves Sleep and Concentration in Children

Choosing the Best Braces Options: A Guide from Your Orthodontist in Brookfield

Adult Orthodontics in Brookfield and Mukwonago, WI: It’s Never Too Late to Transform Your Smile

Where to Find Us

Brookfield

Mukwonago

Start Your New Smile Today

Schedule Your Complimentary Consultation, No Referral Necessary