referral card_2c

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Help Share a Smile AssociatesInDentistry.com Refer a Friend! Bartonville (309) 697-2228 Canton (309) 647-3331 Elmwood (309) 742-2071 Peoria (309) 686-4900 Washington (309) 444-8481 Ask for your FREE Gift! ...and

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Page 1: Referral Card_2C

Help Share a Smile

AssociatesInDentistry.com

Refer a Friend!Bartonville(309) 697-2228

Canton(309) 647-3331

Elmwood(309) 742-2071

Peoria(309) 686-4900

Washington(309) 444-8481

Ask for your FREE Gift!...and

Page 2: Referral Card_2C

We Appreciate You!

Name

Address

Phone

Reference Name

Relationship

We would love to help your family, friends and co-workers too! Refer a friend and you will both get a FREE thank you gift!

Call Today!* For new patient referral only. Gift awarded after your referral is seen for new patient exam. Patients have no obligation to make referral.