Apply for Care

If you or someone you love is disabled or neurodivergent and is facing a serious dental problem that you can't afford to treat, you are welcome to apply. After you apply, we bring your case to a dentist experienced in caring for patients who may need sedation. If the dentist accepts the case, treatment takes place in their office, with an anesthesiologist when sedation is needed, and we pay the providers directly. We focus on serious dental problems that can be addressed in one or two visits, not routine cleanings. We currently serve the San Francisco Bay Area. If you live elsewhere but can travel here for treatment, you're welcome to apply. We're just getting started, and we hope to grow across California. A few honest words. Applying is the first step, not a guarantee. We're a new foundation with a small network of dentists, and each case depends on finding a dentist who is willing and able to provide treatment. We read every application personally.

Patient's first name or initials

Patient's age

Your name and relationship to the patient

Phone

City and State

Can the patient travel to the San Francisco Bay Area for treatment?

Please tell us about the disability, neurodivergence, or support needs that make dental care more challenging, so we can understand the kind of care and support that would help. Share only what you're comfortable sharing.

In a few sentences, what is the dental problem or treatment needed?

Does the patient need sedation or general anesthesia to receive dental care?

Has a dentist already examined this problem?

Is the cost of this treatment a barrier for your family?

What kind of support would help the patient feel comfortable in the dental office? For example, a weighted blanket, calming music, noise-canceling headphones, dim lighting, a familiar support person, extra breaks, a pre-visit, or anything else that helps.

Anything else you'd like us to know? (optional)

To find care for your family, we share the information in this application, including the patient's medical and dental history, with dentists and anesthesiologists who may take the case. Applying does not guarantee treatment. A participating dentist has to accept the case.

I authorize It Starts With A Smile Foundation to share this information with potential treating providers, I confirm the information is accurate, and I understand that applying does not guarantee treatment.

Apply for Care

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