Refer a Patient

Thank you for trusting us with your patient. Since 1994, Jungle Roots has cared for children and teens across Ahwatukee, Chandler, Laveen and Tempe — pediatric dentistry and orthodontics under one roof. Send us the referral below and our team will contact the family to get them scheduled.

What happens next

  1. We receive your referral the moment you submit this form.
  2. Our team calls the family to schedule, usually within one business day.
  3. We follow up with you after the visit.

Send a referral

Please share the patient's information and the best way to reach your office. Fields marked required must be filled in.

Questions about a referral?

(480) 759-1119

Call us and ask for our referral coordinator. We are glad to talk through a case before you send it.