Applications are accepted through mail only.
Download and print the application below or contact us to have it mailed or faxed to you.
Applicants must complete each page of the application and include proof of income.
Download Application

Please read through the patient eligibility requirements prior to applying.

Please mail all completed applications to:
Eastern Oklahoma Donated Dental Services

9810 E 42nd St, Suite 210
Tulsa, OK 74146