Next Patient Dental · Client referral program

Refer a practice.
Get rewarded.

Know a dentist who could use our help? Introduce them to Ernie and Kyle. We’ll take it from there.

01
Make the introduction
Share the practice’s details below.
02
They meet with us
Earn $75 when they complete their audit call.
03
They become a client
Earn $500 when they sign; $1,000 after your first 20 signed referrals.

Who should we meet?

Your name, email and the practice name are required. Everything else is optional.

About you

Full name *

Email *

Phone

How do you know the practice?

The practice you're referring

Practice name *

Their email

Their phone

Anything we should know?

Add practice details & gift-card preferences (optional)

Never include bank numbers, card numbers or patient information.

Company (if any)

Mailing address

Used for physical gift cards and any required tax forms.

Doctor / owner name

Best contact person

Their website

City / state

Do they know you're referring them?

Email for digital gift cards

Leave blank to use the email above.

Gift card format

Name for the gift card

Referral terms

$75 Visa gift card for each referred practice that completes an audit call.
$500 Visa gift card for each referred practice that signs with Next Patient Dental.
Once you've referred 20 signed practices, each additional signed practice earns $1,000.
Rewards are one-time Visa gift cards, not monthly commissions.
A referral counts if the practice wasn't already in talks with us.

I agree to these referral terms and to be contacted about this referral.

Business contact details only. Privacy & data handling

nextpatientdental.com/referral