Maryland Foundation of Dentistry (MFD)
Maryland Foundation of Dentistry (MFD)
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  • Home
  • Donate
  • Application
  • About Us
  • Volunteer
  • Contact Us
  • ORAL CANCER AWARENESS
  • Partners and Sponsors
  • Patient FAQs
  • Support MFD on Amazon
    • Amazon Smile
  • MFD Stories
    • MFD Stories
  • Join us
  • Donate Today

New Patient Application

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Mail completed applications to:  The Maryland Foundation of Dentistry, 8901 Herrmann Drive, Columbia, MD 21045  

       

 OR  Fax: 1-410-964-9978    


Questions or need an application mailed to you call: 410-964-1944

          

MFD New Patient Application (doc)Download

The Maryland Foundation of Dentistry Informational Applicant

MFD Applicant Flyer (pdf)Download

Eligibility:

To be eligible you must: 

  • Apply and be accepted into the program. 
  • You must be a Maryland adult (18+years) with an intellectual, physical, and/or developmental disabilities and be unable to pay for your dental care.  
  • Those with private dental insurance are not eligible for this program.  
  • All dental treatment and labs are provided at no cost to you in a private dental office.  
  • All patients admitted into the program must have transportation to the dental office and must keep all appointments.  
  • We are not emergency services.
  • If you are accepted into the program, services are once in a lifetime, so after completion of treatment, you cannot apply again. 

  

Please note: Our program is unable to provide sedation services.


Dental benefits:

If you have private dental insurance you are not eligible for this program.

Application procedures:

Step One: 

  • Please complete, sign, and return your application. 
  • Please call us at 410-964-1944 if you have any changes in your information, so we can update your application. 
  • Due to program limitations, we have a waiting list in all counties. 
  • Please include a copy of your SSI/SSDI award letter with this application.


Step Two: 

  • When your application comes up for review, a Patient Care Coordinator will call you to set up a phone interview and obtain additional information that will determine your eligibility for the program.


Step Three: 

  • If you are accepted, the Patient Care Coordinator will send a referral with your information to a volunteer dentist.


Step Four: 

  • You will be contacted by the dentist’s office to schedule an appointment. 
  • It is very important that you do not miss any appointments or arrive late.
  • Failure to keep appointments and be on time will result in termination from the program. 

Mail or Fax Completed Application to:

Fax: 1-410-964-9978

 

               OR


Maryland Foundation of Dentistry 

         8901 Herrmann Drive

         Columbia, MD 21045


Questions:

Please call 410-964-1944 if you have any questions and we would be more than happy to help!

PATIENT FAQS

Who is eligible for services?

To be eligible you must apply and be accepted into the program. 


You must be a Maryland adult (18+years) with an intellectual, physical, and/or developmental disabilities and be unable to pay for your dental care.  Those with private dental insurance are not eligible for this program.  


Please note: Our program is unable to provide sedation services. 

If accepted what will I be charged?

All dental treatment and labs are provided at no cost to you in a private dental office.    

Do you provide emergency services?

No, we are not emergency services.

Does the MFD PROVIDE TRANSPORTATION?

No we do not provide transportation. 


All patients admitted into the program must have transportation to the dental office and must keep all appointments. 

Does MFD provide sedation services?

The MFD program does not provide sedation services.  

My information on my application has changed

Contact us at 410-964-1944 to update your information. 

Dental benefits

Those with private dental insurance are not eligible for this program.  

Can I reapply for services once my treatment has been completed?

If you are accepted into the program, services are once in a lifetime, so after completion of treatment you cannot apply again.

QUESTIONS??

If you have any questions, contact us at 410-964-1944.

Copyright © 2020 Maryland Foundation of Dentistry - All Rights Reserved.  The Maryland Foundation of Dentistry is a 501(c)(3) nonprofit organization.  

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