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Health Care Providers

We work with kids 0-19 years old that have no dental insurance or are on BadgerCare/Medicaid. If you have a patient that fits these criteria, we would love to see them! You can pass on our name to the patient’s parent, or fill out our referral form and send it over. If the patient has severe dental needs, please fill out the reason for referral section.

Dental Providers

If you have a patient that is 0-19 years old with no dental insurance or on BadgerCare/Medicare that would benefit from our services, we would love to work with them! Please fill out and send over our referral form. If the patient has specific oral health concerns, please list that in the reason for referral section.

Forms can be emailed to [email protected] or faxed to 920.965.0834.