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Fill out the Entry Form below for the contest you are entering!

Last Month's Winners

  • Birthday Contest: Ezequiel Ramos
  • Cavity Clearance: Stacy Williams

Birthday Contest Entry Form

To enter the contest, your birthdate must be in the month when you submit your entry. Winner’s account must be current. The drawing will be done on the 5th of every month for previous month’s birthdays!

Don’t forget, you must enter the contest during the month of your birthday!

apr-juneContest_1Cavity Clearance Contest Entry Form

In the next 3 months, we will be having a Cavity Clearance Contest!

To enter the contest, you must go to your dentist for a cleaning and bring back the signed Cavity Clearance Form from your dentist. Then your name will be entered into the contest to win a tablet!

Don’t forget to bring us your signed Cavity Clearance Form from your dentist to complete your contest entry!