Dr. Sam King

Win a pair of Moonlight Roller Skates!

This sweepstakes is open to everyone within our general practice area so be sure to share with friends!

Full Name

Email

Phone

Zip Code

Are you a patient at our practice? (Does not affect chances of winning)

Yes - my child is a patient

Yes - my child(ren) and I are both patients

Yes - I am personally a patient

No one in my family is a patient

Do you have children? If so, how old are they?

No kids as I'm only a kid myself

0-4 years

5-9 years

10-14 years

15-19 years

20+ years

I'm an adult with no kids

If you or your child *ARE NOT* patients at King Orthodontics would you like someone to contact you about a complimentary orthodontic consultation?

Yes - for an adult

Yes - for a child

Yes - for both an adult and a child

No thanks - we are patients already

No thanks - I am not interested

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1 Winner | Ends 7.24.22 | Sweeps Rules