Get the free DENTAL PREVENTION Sliding Discount Eligibility Application

Name: Fillable Online DENTAL PREVENTION Sliding Discount Eligibility Application Fax Email Print - pdfFiller
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If eligible your child will receive dental education and prevention services free of charge. This eligibility is valid for the day of the dental prevention service only. DENTAL PREVENTION Sliding Discount Eligibility Application Siskiyou Community Health Center wants to provide health care to our patients regardless of their ability to pay. Signature Parent/Guardian Date Print Name Parent/Guardian FOR OFFICE USE ONLY DOCUMENTATION RECEIVED/DETERMINATION Family Size Qualifies for Slide...

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How to fill out dental prevention sliding discount

01

Step 1: Gather all necessary documents such as proof of income, residency, and identification.

02

Step 2: Contact your local dental clinic or healthcare center to inquire about the dental prevention sliding discount program.

03

Step 3: Schedule an appointment with a representative from the dental clinic or healthcare center.

04

Step 4: During the appointment, bring all the necessary documents and provide accurate information about your financial situation.

05

Step 5: Fill out the dental prevention sliding discount application form completely and accurately.

06

Step 6: Submit the application form along with the required documents to the dental clinic or healthcare center.

07

Step 7: Wait for the application to be reviewed and processed.

08

Step 8: Once approved, you will be notified about the discount percentage you are eligible for.

09

Step 9: Use your dental prevention sliding discount card or voucher when visiting the dental clinic to avail of the discounted services.

10

Step 10: Remember to renew your application and provide updated information as required.

Who needs dental prevention sliding discount?

01

Individuals with limited income and financial resources.

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What is dental prevention sliding discount?

Dental prevention sliding discount is a discount given to individuals who participate in preventive dental care services.

Who is required to file dental prevention sliding discount?

Dental providers are required to file dental prevention sliding discount for eligible patients.

How to fill out dental prevention sliding discount?

To fill out dental prevention sliding discount, dental providers must submit the necessary information about the discounted services provided.

What is the purpose of dental prevention sliding discount?

The purpose of dental prevention sliding discount is to incentivize preventive dental care and promote overall oral health.

What information must be reported on dental prevention sliding discount?

The information reported on dental prevention sliding discount includes patient details, services provided, and the amount of discount given.

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