Dental Office Application With Sliding Scale In Illinois
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State:
Multi-State
Control #:
US-00413-1
Format:
Word;
Rich Text
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Description
This form is an Employment Application. The form provides that applications are considered without regard to race, color, religion, or veteran status.
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In order to qualify you will need to meet the following requirements listed below and fill out the sliding scale fee application. The Sliding Fee Discount Scales are posted in the Health Centers' waiting room area. 1.The sliding fee application is used to determine eligibility for the sliding scale and to assess the level of discount assigned to the patient. Some patients may qualify for payment assistance. You may fill out this online form KCHC Sliding Fee Scale Programs Application to apply for assistance. The rates at the Dental Center vary on a sliding scale. The Dental Center accepts Medicaid for children. Parkland College Dental Clinic primarily provides cleanings and dental exams, and they do not perform any other dental treatments. Complete treatment may. • Licensed dentists in the State of Illinois.