Giveaway

WIN WIN WIN

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Grand Prize
2nd place
3rd place
4th place

ORTHO Contest Form

Patient Name(Required)

First Last

Email(Required)

Is the patient listed above 18 years of age or older?(Required)

Yes, they are over 18.

No, they are under the age of 18.

Parent/Legal Guardian Name(Required)

First Last

Phone(Required)

Your Practice(Required)

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Eligibility(Required)

I certify that the person listed above is a patient of The Dental Specialists Orthodontics who is at least 18 years of age or if the person listed above is under the age of 18, they have the consent of their parent or legal guardian to enter this contest.

NEEDS TO BE UPDATED!

NO PURCHASE NECESSARY TO ENTER OR WIN. PURCHASE WILL NOT ENHANCE CHANCES OF WINNING. Odds of winning depend on the number of eligible entries received. Must be as natural persons who (a) are active patients of Sponsor, but for whom Sponsor does not receive reimbursement for services from federally funded government programs, (b) are legal residents of the 50 United States, excluding Florida, Rhode Island and New York, and (c) have reached the age of majority in their state of residence or older as of the date of entry. Sweepstakes runs from 12:00am CDT on August 15, 2021 to 11:59pm CDT on October 13, 2021. Approximate maximum aggregate value of all prizes is $500. By participating in the Sweepstakes, entrants agree to the full Official Rules. See the Official Rules for complete details, method of entry, and qualifications, available at XXXwebsiteXXX.