Application

No walk-in applications. Applications are accepted through mail only.
Mailing Address:
E.O.D.D.S.
7060 S. Yale Ave., Suite 707
Tulsa, OK74136

Patients Application Download:

Download (.docx) Download (.pdf)(Applicants must complete the entire form.)

 

Patient Application Request Form / Volunteer Dentist Form

The below form is for new patients requesting an application be mailed to their address -OR- Dentists interested in volunteering (Select ‘Yes’ for additional required fields)

 

**PATIENTS** THIS FORM IS NOT FOR SUBMITTING YOUR APPLICATION INFORMATION, OR ANY OTHER SENSITIVE MEDICAL INFORMATION, AND IS FOR SUBMITTING YOUR ADDRESS AND CONTACT DETAILS ONLY. WE APPRECIATE YOUR UNDERSTANDING.

Thank you – E.O.D.D.S. staff