Client Eligibility Criteria

Disabled Clients must be physically or mentally disabled, low-income, drawing their Social Security Disability (SSD) or Supplemental Security Income (SSI). Clients may not have any savings accounts, CD'S, Trust accounts, IRA'S or any other means of paying for dental care.

Frail Elderly Clients must be 65 years of age or older and low-income. Clients may not have any savings accounts, CD'S, Trust accounts, IRA'S or any other means of paying for dental care.

All Clients must meet the current year Annual Federal Poverty Guideline.

E.O.D.D.S. may make exceptions if the client is in a life-threatening situation or extreme pain.

Thanks to Delta Dental Oral Health of Oklahoma Charitable Foundation EODDS has limited special funding annually to provide denture/partial dentures only to low-income eastern Oklahomans who live in the (918) and (539) area code region and don't meet our regular guidelines. All other dental work must be completed. Please call the EODDS office for an application or please download one and mail in.

Thanks to the George Kaiser Family Foundation and the J.A. and Leta M. Chapman Charitable Trust EODDS has added a Vulnerable population program (Program II). EODDS will be providing services to women in the Healthy Women/Healthy Futures Program, Women in the Alternatives to Incarceration Program, Tulsa Medical Access Programs. If you are referred to EODDS by any of these programs please download the referral application that has Vulnerable Population Program and include the patient responsibility contract and the Authorization for Access and Disclosure form and mail all three to the EODDS office. Thank you

Form Downloads

Applications accepted by mail only!

(These forms will open a new window. You might need to enable pop-ups for this site)

NOTE: You need to fill out and send all three forms to be put on our waiting list.

FORM 1: EODDS_application.doc
FORM 1: EODDS_application.pdf

FORM 2: AUTHORIZATION FOR ACCESS AND DISCLOSURE.doc
FORM 2: AUTHORIZATION FOR ACCESS AND DISCLOSURE.pdf

FORM 3: EODDS PATIENT RESPONSIBILITY CONTRACT.doc
FORM 3: EODDS PATIENT RESPONSIBILITY CONTRACT.pdf



 

Vulnerable Population Downloads

Applications accepted by mail only!

(These forms will open a new window. You might need to enable pop-ups for this site)

NOTE: this form is for Vulnerable Population Applicants ONLY!

FORM 1: Vulnerable Population Application.doc
FORM 1: Vulnerable Population Application.pdf