Dental Visit_Certificate.pdf - Petrol Orthodontics

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					                                 Petrol Orthodontics
                                       Dental
                                               REWARD CERTIFICATE


                                                 Patient Name


  I am a patient of Petrol Orthodontics and earn reward points for regular dental check ups.
         Bringing in this Dental Reward Certificate at my next orthodontic appointment
                        guarantees points will be added to my Rewards Card.


Dentists, Hygienists and Dental offices can earn reward points too. Each completed certificate
           will be entered into a drawing for a special gift from Petrol Orthodontics.


                                  Thank you for completing this certificate!



                 This certifies that the above patient has completed the following:


                                          Requested Dental Treatment Completed

                                          Dental Exam/Cleaning


  Dr. or Hygienist’s Initials:   _________________       Appointment Date:   __________________


  Dr. or Practice Name:   _____________________________________________________




                                                    Murrieta Office
                                                    41011 California Oaks Rd, Suite 201, Murrieta, CA 92562
                                                    Temecula Office
                                                    31537 Rancho Pueblo Rd, Suite 205, Temecula, CA 92592
www.petrolorthodontics.com
                                                    Menifee Office
      951-698-8200                                  29826 Haun Road, Suite 101, Menifee, CA 92586

				
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