1. Patient must be a resident of Dane County

2. Individuals must have NO private dental insurance (BadgerCare, Medicaid plans accepted)

3. Individuals must have family income below 200% of Federal Poverty Level

 

Registration forms

1. Patients must bring proof of residence such as:

  • Driver’s License
  • Utility Bill
  • Cable Bill
  • Lease

2. Patients must submit proof of family income such as (Bring all that apply)

  • Food Share
  • Social Security and SSI
  • Wages from job
  • Unemployment/Worker’s Compensation
  • Pension
  • Last year’s W2 or 1099
  • Child Support