Individuals must live in Calumet, Outagamie, or Winnebago County.
Individuals must have NO dental insurance.
Individuals must have family income below 200% of federal poverty level or a Forward Card (Badger Care or Title XIX)
Registration
Patients must register in person before being given an appointment.
Patients must bring proof of residence in one of the 3 counties such as a utility bill.
Patients must bring proof of family income - Forward Card or proof of family income (examples - last year's tax return, last 3 pay stubs, unemployment statement, social security statement.)
Important Information
CO-PAYS ARE REQUIRED AT EVERY APPOINTMENT AND MAY ONLY BE PAID IN CASH.
You will be required to make a co-payment based on a sliding scale according to your income. The maximum co-payment for a regular appointment will be $25.00.
Bring proof of your family income and residence to EVERY appointment.
Arrive 15 minutes early to each appointment to fill out necessary paperwork.
If you miss an appointment you will not be seen for ONE YEAR.
Care may be provided by Marquette University School of Dentistry dental students or a Fox Valley Technical College dental hygiene student under the supervision of one of our local volunteer dentists.
Children
Children under 18 must be accompanied by a parent or legal guardian at every appointment.
Children must be supervised in the waiting area.
Children not receiving treatment must remain in the waiting area. They may not accompany an adult or other child in the treatment room.