Notes to Dr. Wallace Falero
Please include your contact information and note of thanks or encouragement to Dr. Falero in the space below. Notes may be submitted without a name if preferred. Notes or cards may also be mailed to or dropped off at the clinic before October 29.
Name
First Name
Last Name
E-mail
Phone
Note to Dr. Falero
Can we share your note in a newsletter or social media post?
Yes, you may share my note and my name.
Yes, you may share my note but NOT my name.
No, my note is only for Dr. Falero.
Submit
Should be Empty: