DDS Patient Application

ELIGIBILITY: Dentists in your state have volunteered to provide dental care. They do this for free to eligible applicants If you have a permanent disability, over 60 years old, or a female veteran, and don’t have enough money to pay for dental care, you may qualify for free treatment through the DDS program.

COST: People who qualify usually pay nothing. Occasionally, people who can pay for part of their care may be asked to do so, especially if you need laboratory work.


Step One - Complete entire application to the best of your ability.   Please click here to print the application.

Step Two -When we get your application, we will decide if you appear eligible for the program. If you appear eligible, we will put you on the waiting list in the order your application was received. If you are not eligible, we will send you a letter of denial.  Depending on where you live, the wait will be several months or can be up to several years.  

Step Three - When your application comes to the top of the waitlist, DDS will contact you. If the coordinator determines you are eligible, you will be referred to a dentist. If a dentist agrees to see you, you will schedule an appointment. Final acceptance into the program will be made only after the first appointment with the dentist.

We are sorry you are experiencing a dental problem and we hope the Donated Dental Services (DDS) program may be of some help.


Please click here to print the application.  The completed and signed application can be mailed, emailed or faxed to Donated Dental Services. 

P.O. BOX 16854

PHONE: (505) 298-7206 ext. 203
FAX (505) 554-3836