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gum brand Sign Up Information

Last Updated:
11/10/2019
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Thank you for subscribing to our newsletter.

To begin receiving the newsletter, you must first confirm your subscription by clicking on the following link:

https://www.gumbrand.com/newsletter/subscriber/confirm/id/124787/code/v5ac50xzgmy7sahf0al3h54pflnoy6r6/

 

Gumbrand is contacting you because you have requested to receive updates about new products, events and special offers.

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©Sunstar Americas, Inc. | 301 E. Central Road | Schaumburg, IL 60195 | United States
All rights reserved.
GUMbrand | 1-888-777-3101 | us.pcr@us.sunstar.com

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Registration
Birth Date
First name
Last name
Email
Zipcode
Gender
Gender
Zip Code
None, prevention only
Oral Care Conditions
Periodontitis
None, prevention only
Oral Surgery
Periodontitis
Braces/Retainers
Oral Surgery
Cold sores or Mouth Sores
Braces/Retainers
Hard to clean spaces between my teeth
Cold sores or Mouth Sores
Gingivitis
Hard to clean spaces between my teeth
Tooth Sensitivity
Gingivitis
Implants/Bridges
Tooth Sensitivity
Dentures/Removable partials
Implants/Bridges
Diabetic
Dentures/Removable partials
Other
Diabetic
Data Name Data Type Options
Birth Date   Text Box
First name   Text Box
Last name   Text Box
Email   Text Box
Zipcode   Text Box
Gender   Text Box
Gender   dropdown
Zip Code   number
None, prevention only   checklist Oral Care Conditions
Periodontitis   checklist None, prevention only
Oral Surgery   checklist Periodontitis
Braces/Retainers   checklist Oral Surgery
Cold sores or Mouth Sores   checklist Braces/Retainers
Hard to clean spaces between my teeth   checklist Cold sores or Mouth Sores
Gingivitis   checklist Hard to clean spaces between my teeth
Tooth Sensitivity   checklist Gingivitis
Implants/Bridges   checklist Tooth Sensitivity
Dentures/Removable partials   checklist Implants/Bridges
Diabetic   checklist Dentures/Removable partials
Other   checklist Diabetic

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Comment by: admin
Comment on: 01/09/2020