Doctor / Patient Referral Form

You may refer patients to our office by submitting the Patient referral form below.
We also offer a PDF option that be downloaded, completed, and sent electronically back to us.

Dr. Keith Koch and the team at Koch Orthodontics are experts in braces. If you have any questions pertaining to Invisalign, Invisalign Teen, braces and clear braces in Livingston County NY, 14454 zip code area, Geneseo NY, Henrietta NY, Rochester NY and Finger Lakes NY or would like to schedule a complimentary consultation with Dr. Keith Koch contact Koch Orthodontics at: 585-243-3174.