Build stronger referral relationships with a professional resource designed specifically for your myofunctional practice.
 
Our Custom Myofunctional Referral Pads give dental and healthcare providers an easy way to recognize potential oral function concerns, document what they're noticing and connect patients directly with your practice.
 
We'll customize the referral pad with your branding, contact information and referral process, then professionally print your finished design into 25-sheet tear-away pads ready to distribute to referring offices in your community.
 
Customized for Your Practice
 
Your referral pad can include:
Practice logo and brand colours
Practice name and contact information
Website and/or social media
Custom QR code linked to your booking or referral page
Personalized call-to-action and next steps
Provider and patient information fields
Oral function findings checklist
Provider notes section
Healthy oral function education
The goal is to give your referral network a resource that's simple to use chairside, educational for patients and clearly connected to your practice.
 
Choose Your Order Type
First Order – New Custom Design
Choose this option if we have not previously created your referral pad. Your order includes a one-time $149 custom design fee, customization to your practice, a digital proof and one round of minor revisions.
Once your design is approved, we keep it on file for future orders—you will not pay the design fee again when reordering the same design.
Reorder – Existing Design, No Changes
Already have an approved referral pad on file with Airways Academy? Choose this option to have your existing design printed exactly as previously approved. No additional design fee applies.
Reorder – Existing Design + Minor Changes
Choose this option if you already have an approved design on file but need a small update before reprinting. A $35 update fee is included in the price.
Minor changes may include updating a provider name, phone number, email address, website, booking link, QR code or other small text changes.
Significant changes to the layout, branding or overall content may require a new custom design.
 
Choose Your Quantity
Every referral pad contains 25 full-colour tear-away sheets.
10 pads = 250 referral sheets
25 pads = 625 referral sheets
50 pads = 1,250 referral sheets
100 pads = 2,500 referral sheets
Ordering a larger quantity reduces the cost per pad, making it easier to provide referral pads to more offices throughout your community.
 
How It Works
After placing your first order, we'll contact you to collect your logo, brand colours, practice information, website or booking link, QR code destination and customization preferences.
We'll create your custom referral pad and send you a digital proof for approval before printing. One round of minor revisions is included with your initial design.
Once approved, your referral pads will be professionally printed and shipped to you, ready to distribute to your referral network.
For future orders, simply select the appropriate Reorder option and your desired quantity.
 
Product Details
Professionally printed custom referral pads
25 sheets per pad
Full-colour printing
70 lb uncoated paper
Tear-away pad format
Customized with your practice branding
Digital proof included with new designs
One round of minor revisions included with new designs
Available in quantities of 10, 25, 50 or 100 pads
Professionally printed and shipped to you
 
Designed for Myofunctional Providers
These referral pads are ideal for myofunctional therapists looking to build relationships with dentists, dental hygienists, orthodontists, pediatric dental offices, SLPs and other healthcare professionals in their communities.
Leave a pad with a referring office so their team has an easy, consistent way to recognize potential concerns and direct appropriate patients to your practice.
 
Please Note
This is a custom, made-to-order product. Please carefully review your digital proof before approval. You are responsible for confirming the accuracy of your practice name, contact information, QR codes, links, spelling and other customized information.
Custom products are not eligible for returns or exchanges. If your order arrives damaged, incorrect or you experience another issue with your order, please contact us so we can help.
 
Shipping is calculated separately at checkout.
 
Looking to print your referral pads yourself? Our Custom Myofunctional Referral Pad – Digital Print-Ready File is available separately for $149 CAD.