About This Clinic
SERVICES WE PROVIDE
Dental Services
Tooth Extractions for adults and children
Tooth Fillings for adults and children
Dental Hygiene
Acute problem visits
Dental impressions and Dentures
Counseling
Services area available to individuals, families, adults, and children
Biblically based counseling services are offered
Health Education
Dental Hygiene
Dental Sealants
Nutrition counseling
Education is offered one-on-one
Social Services
We provide contact information to appropriate social services agencies for patients needing additional assistance.
The clinic is open for Financial Screenings on the 1st and 3rd Tuesday of every month between 9am-12noon. Appointments are necessary. Please call for an appointment as well as a list of items to bring to your appointment so that you may prove your HOUSEHOLD INCOME, such as:
Patient Information (or Patient’s Father-if child):
If you are employed, bring:
Last 3 Paycheck Stubs
Last 3 months of Bank Statements
W-2 VERIFICATION/1099
Copy of Tax Return
If you are not employed, bring:
Proof of Social Security or Disability Benefits
Proof of Government Assistance
Unemployment Letter
Application Inquiry Form (Dept. of Labor)
Separation Notice
Spouse's Information (or Patient’s Mother- if child) :
If you are employed, bring:
Last 3 Paycheck Stubs
Last 3 months of Bank Statements
W-2 VERIFICATION/1099
Copy of Tax Return
If you are not employed, bring:
Proof of Social Security or Disability Benefits
Proof of Government Assistance
Unemployment Letter
Separation Notice
*Patients with no income, require an official document such as: a Non-Filers statement from the IRS, income Tax return, a statement from the unemployment office, a termination letter from a recent employer, or verification of benefits from the DFACS office.
Must have: Picture ID _____ Utility Bill_________
OTHER WAGES or applicable documentation: (child support income, alimony, stimulus funds, food stamps, rental income, royalties, interest dividends, insurance payments, self-employment, workers compensation, retirement benefits, pensions, unemployment ,training stipends, scholarships, military allotments, AFDC, TANF, SSI, etc.)
Anyone providing false information will be terminated from the program.
Patients not providing necessary documentation will not be eligible for services.
Our policy requires that income information must be updated and verified at least once a year.
Patients requiring dental procedures will be scheduled an appointment as the volunteer dentist and staff becomes available. Usually patients will be seen on days in which dentists will volunteer their time, more commonly, on Mondays or Fridays.
To schedule an appointment call:
478-953-7770
Staff Hours: Monday-Friday 9am -4pm
2022 US Federal Poverty Guidelines
for the 48 contiguous states and the District of Columbia
Persons in family / household | Poverty guideline |
---|---|
1 | $13,590 |
2 | $18,310 |
3 | $23,030 |
4 | $27,750 |
5 | $32,470 |
6 | $37,190 |
7 | $41,910 |
8 | $46,630 |
For families/households with more than 8 persons, add $5,430 for each additional person. |