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DENTAL EXAMS AND TOOTH FILLINGS Where: Healthy Smiles for Kids of Orange County Clinic 10602 Chapman Ave, Ste. 200 Garden Grove, CA 92840 Who: Children 5 and older When: Saturday, December 2, 2017,
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Start by opening the Healthy Smiles for Kids form.
02
Fill in the child's personal information, including their full name, date of birth, and address.
03
Provide the child's health insurance information, such as the insurance company's name and policy number.
04
Next, fill out the parent or guardian's details, including their name, contact information, and relationship to the child.
05
If applicable, provide any additional information about the child's dental history or specific dental needs.
06
Review the form to ensure all information is accurate and complete.
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Sign and date the form at the designated spaces to certify that the provided information is correct.
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Submit the completed Healthy Smiles for Kids form to the appropriate recipient or organization.
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Who needs healthy smiles for kids?

01
Healthy Smiles for Kids is designed for children who require dental care or services.
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This program benefits children from low-income families or those who may not have access to affordable dental care.
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Children who are eligible for Medicaid or State Children’s Health Insurance Program (SCHIP) may also benefit from Healthy Smiles for Kids.
04
The program aims to ensure that all children have access to necessary dental services for maintaining good oral health.
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Healthy Smiles for Kids is a dental program aimed at providing dental care and education to children, promoting good oral health practices.
Parents or guardians of children seeking dental assistance or benefits through the Healthy Smiles for Kids program are required to file.
To fill out Healthy Smiles for Kids, applicants need to complete a specific application form that collects personal information about the child and their dental needs.
The purpose of Healthy Smiles for Kids is to ensure that all children have access to dental care and to educate families about maintaining oral health.
The information that must be reported includes the child's personal details, household income, and any previous dental care received.
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