Refer a friend to Merit Dental & you
both could win a $50 Visa Prepaid Card.

Referral (Your Friend's Information)

Referred By (Your Information)

Office Location

Select Your Office

Message to your Referral

*NO PURCHASE NECESSARY TO ENTER OR TO WIN. SUBJECT TO APPLICABLE FEDERAL, STATE, LOCAL AND MUNICIPAL LAWS AND REGULATIONS. VOID WHERE PROHIBITED. Eligibility: Sweepstakes open to anyone age 18+. Employees of Merit Dental Management, Inc. and its affiliates are not eligible. Entry not contingent upon successful referral of a new patient. No purchase necessary. A maximum of five sweepstakes entries allowed per individual, per calendar year. Sweepstakes begin anew every three months. One entrant per participating office will be drawn at random from among all entrants for the given time period to receive a $50 Visa prepaid card. If the winner referred a new patient, both patients would receive $50 Visa prepaid cards. If the winning entrant did not refer a new patient, only one $50 Visa prepaid card will be distributed. Winners will be notified within two weeks after the drawing and will be contacted via telephone or email depending on information available. Value of prizes not to exceed $50. No sweepstakes participant may win more than once in a 12 month period. Not valid with state or federal programs. Prizes are not transferable, except at the discretion of Merit Dental Management, Inc. For a copy of these official rules, send a self-addressed, stamped envelope to Merit Dental, Attn: Marketing, 3500 American Blvd. W., Ste. 130, Bloomington, MN 55431. Merit Dental Management, Inc. is not responsible for lost, stolen or illegible entries.

I Have Read and Understand the
Program Rules and Restrictions