Friendly Smiles Program
DCDC’s Friendly Smiles is an outreach program that brings FREE diagnostic, preventive, and operative dental services to area schools. Children who are uninsured that qualify for the free and reduced lunch program at school or children who have a medical card or commercial insurance are eligible to participate.
The Douglas County Dental Clinic extends its helping hands into area schools with the following on-site services:
- Fluoride Varnishes
- Silver Diamine Fluoride
- Dental Sealants
Call Hannah at 785-312-7770 x206, email her at email@example.com, or inquire with your school nurse, to see if we currently provide services at your child’s school. Consent forms are required for participation in school-based services.
Print Out Our Friendly Smiles Enrollment Consent Forms
Does our Friendly Smiles team go to your child’s school? (see list) Please print and fill out our Friendly Smiles enrollment form to sign your child up for our program. You can turn the form in with your school nurse or bring it by the clinic.
2019-2020 Friendly Smiles Consent Form
Secure Online Enrollment Forms Are Available
We offer a secure method of submitting our Friendly Smiles application online. If you have any questions, please contact our Friendly Smiles Coordinator, Hannah.
- Online Form: English CLICK HERE
- Online Form: Spanish CLICK HERE