Refer a Friend

Our Patient Referral Program

You referral is our best thank you!

Did you know that we have a patient referral program? We'd love to thank you for your referral of a friend or family member. Contact us to find out more!

We know your time is valuable, so we have online booking available as well as same day start options with discounts.

Don't keep us a secret, we'd love to help your friends and family achieve their best smile at South Surrey Smiles.

A young man and woman are standing outside and laughing while looking at a phone.

Referrer Information

Name

Email Address

Phone

Friend Information

Friend's First Name

Friend's Last Name

Friend's Date of Birth

Parent / Guardian Names (if applicable)

Friend's Phone

Friend's Email

Reason for Consultation / Comments

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