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Home
Infant/Children
Infant Tongue-Tie Process
BabyLase
AirSync's Tongue-Tie History
Less Than Six Years
The Littles Initiative
Breastfeeding Support
Tongue-Ties
Signs + Symptoms Associated with Tongue-Ties
When To Treat
How We Treat
Truths About Tongue-Ties
Laser vs. Scissors
Sleep & Airway
Resources: websites, books, videos, scientific literature
Airway Orthodontics
The Gift of MARPE
Myofunctional Therapy
Awesome Laser Therapies
Fun Reading
CPAP Alternatives
Trouble Sleeping?
Sleep Apnea
Dentistry
All Dental Services
Pediatric Dentistry
Preventive Healthcare
Cosmetic & Restorative
About
Meet Dr. Santiago
More Than Teeth
What is AirSync
Contact Us
Blog
New Patients
Contact
Forms
FAQs
Insurance
Referring Providers
Patient Referral Form
Please complete the referral form below
Patient's Name:
*
First Name
Last Name
Patient’s Age:
*
If patient is a minor, parent’s name:
*
Email:
*
Patient's Phone:
*
Reason For Referral:
*
Growth Guidance
Forward Orthodontics
Migraines
TMJ
Esthetics
Mouth Breathing
Suspected Breathing
Disordered Sleep
Bed-Wetting
Recurrent Ear Infections
Snoring
ADHD
Other
If you answered "other" please list the reason here:
Current Therapies (i.e. speech, myofunctional therapy, orthodontics)
*
Referring Provider
*
Thank you!