Submit a referral online.
Complete the form below and the office contacts your patient to schedule. Every referred patient is evaluated personally by Dr. Basma Fallah, a Diplomate of the American Board of Orthodontics since 2007 — and you receive her findings in writing.
The professional referral form.
Nothing to print or fax — fill it in here and it arrives at the office immediately.
Prefer to call, or discuss the case first?
Call the office — (817) 581-8881
Want to talk a case through with Dr. Fallah before you send it? The line accepts calls and texts.
For Referring Doctors
What you receive back on every referred patient, and how the practice handles airway findings outside the orthodontic scope.
Every intake includes a low-radiation CBCT airway evaluation. When imaging shows something beyond the orthodontic scope, Dr. Fallah refers on to a pediatric ENT and copies you.
Questions about a specific case? Contact the office.
09 — Intake
Begin with an evaluation.
Your first visit at NRH Orthodontics is a full evaluation — CBCT airway screening included — and a treatment plan you understand before you commit to anything.
Accepting new patients — North Richland Hills, TX