
		Michael W Richard, DDS, PA
		2702 Campus Drive \| Garden City, KS 67848 \| Ph. (620) 271-7474

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Refer Our Office

One of the highest compliments a dental practice can receive is when a patient refers a friend, co-worker, or relative. We have made this process simple and easy to use in the section below. Thank you for entrusting us with the care of someone in your life. We guarantee they will receive the same high standard quality of care you have already come to expect from us. After completing the section below:

To refer a friend fill out the information below.

An Email will be sent to the address you have provided.
We will contact your friend if they respond saying that they would like more information about our office.
Thank you for referring us to your friends.


	*Friend's first name:	*Friend's last name:
	Friend's phone number:
	*Friend's email address:
	*Your first name:	*Your last name:
	*Your email address:
	Notes:
	* Required field