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Entry Form

Thank you for taking part in Truly Dental’s
exciting journey to bring life-changing smiles
to those who need it most.

 

Whether you’re nominating yourself or someone close to your heart, this is
your chance to make a real difference. Fill out the form below and share
their story with us!

 

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Your Information

Nominee’s Information

Only fill this in if you're nominating a loved one. Leave blank if not applicable

Please explain why you believe you/they deserve to be nominated.

In what ways could this treatment be life-changing for them/you?

Supporting Photo

Share a close-up photo so we can put a face to the name. (smiling if possible)

(This photo will be used internally to help our full arch surgeon, Dr. Jimmy, assess the case.)

Supporting Video (Max size 5mb)

Please upload a video explaining why you or your loved one should be selected. We’d love to hear why you’re the perfect candidate for this life-changing giveaway. Just be yourself!

Add your video link

Where did you hear about this giveaway?