Glacier Dental Clinic

This is a SLIDING SCALE clinic. The costs for clinic services are based on either your income or they offer type of financial assistance. Contact the clinic directly to discuss prices for individual services which vary. Sliding Scale does not necessarily mean free.

Services:
Family and General Dentisry
Family Medicine
Sliding Fee for Service:
Patients that qualify financially based on their gross household annual income and family size using the federal guidelines for poverty will be granted a discounted fee for service.
Patients can refer to the sliding fee chart to determine what level for which you may qualify. To apply for the sliding fee discount, please complete the ‘Application for the Sliding Fee Discount Program’ form and bring in proof of financial status from all sources of income in your family. One or more of the following are accepted:
 Tax forms from most recent year
 Pay check stubs for one month (preferably with year to date income provided)
 Office of Public Assistance benefit printout (example: food stamps)
 Fixed income statement (example: pension or bank statements showing deposits)
 Letter on agency letterhead verifying financial status(example: Housing Authority)
 Student Grant Information/SARS