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Dr. Durbin
Dr. Douglas Durbin
Mission and Vision
Our 7 Locations
Lexington
Georgetown
Winchester
Mount Sterling / Owingsville
Richmond
Nicholasville
Boynton Beach, FL
Services
Virtual Appointments
Convenience Invisalign
Clear Aligners
Invisalign®
Orthodontic Services
Traditional Braces
Surgical Procedures
What is the Right Age?
ACCELEDENT® OPTIMA™
Smile Gallery
Reviews
Miss Kentucky Testimonial
Patient Education
Welcome Video
Educational Videos
Blog
Invisalign Instructions
Frequently Asked Questions
Oral Hygiene
Glossary of Orthodontic Terms
No-No Food List
Waterpik
Mouthguard Instructions
Dr. Durbin's Retainer Research
New Patients
Health History Form
Financing
My Old Kentucky Home
K-12 Appointment Policy
New Patient Referral
Doctor Referral
Contact
860 Corporate Drive Suite 201,
Lexington,
KY
40503
859-279-4450
200 Bevins Lane Suite F,
Georgetown,
KY
40324
502-276-9676
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Dr. Referral Form
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Patient's Name
Patient D.O.B.
Contact or Responsible Party (if minor):
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Reason for Referral
General Orthodontic Evaluation
General Orthodontic Evaluation
Crowding
Crowding
Spacing
Spacing
Harmful Habits
Harmful Habits
Openbite
Openbite
Overbite
Overbite
Overjet
Overjet
Underbite/Crossbite
Underbite/Crossbite
TMJ Dysfunction
TMJ Dysfunction
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