As someone who used to work in the orthodontics fields in both Oregon and Washington (Washington actually covers ortho treatment for kids who recieve state aide, which is awesome!) you don't need any type of referral from a general dentist. Referral are used by the ortho office to see which general dentist sends us the most patients, just so we can kiss their butts so they can keep sending us clients. You can literally just call and set an appointment because you want to change your smile.

If an orthodontist charges you for the consultation run out the door, they plan to charge you for every meniscal thing they can. A reputable orthodontist will at least give you options before you sign or pay anything.