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How to become a Patient

To become a patient

  • To become a patient, your household income must be at or under 200% of the Federal Poverty Level. 
  • Patients without dental coverage, which includes private dental insurance and/or Medicaid coverage
  • Each patient will need to present proof of individual and household income. Types of accepted proof of income include: four weeks of paycheck stubs, Social Security Award letter, pension verification letter, etc. (see button below to submit forms)
  • The paperwork will be reviewed and verfied by our staff and the patient will be notified once application is approved so that appointment may be scheduled.
  • Each patient will need to present their Drivers License or Florida State ID card showing their current Pinellas County address.

Submit Income Verification

What to expect after application

  • The average wait time from application approval to appointment is three months.
  • The wait time for subsequent appointments is typically three months.
  • Typical services include: exams, cleanings, fillings, extractions, and dentures




Patient Guidelines

  • Be on Time. When we schedule your appointment, we reserve a room and appropriate dental team members for your specific needs. If you need to change an appointment, please give us at least 48 (business) hours' notice. This courtesy allows us to offer your reserved dental team and room to another patient in need. Your first unexcused missed appointment will result in a verbal warning. A second unexcused missed appointment will lead to the loss of future appointment privileges. If you are more than 10 minutes late, we may need to reschedule your appointment.
  • Confirm your appointments. We will call one to two business days before your dental appointment as a courtesy to confirm. If we leave a message, you must contact us to confirm your appointment. It is your responsibility to update your contact information. This helps us stay in touch with you regarding confirmations, treatment, and appointments. You can leave a message if we do not answer, if you do not confirm your appointment, you may be asked to reschedule upon arrival.
  • Be Proactive in Your Treatment. Our goal is to provide you with a comprehensive dental treatment plan to help you achieve healthy teeth and gums. It is in your best interest to follow the treatment plan that has been recommended for you. If you have questions or concerns regarding your treatment plan, we will gladly schedule time for you to discuss them with our Dental Director. However, if an agreement for treatment cannot be reached, you risk being dismissed from the clinic. 
  • Be Respectful to Our Volunteers and Staff at All Times. Our volunteers donate their time to provide you with no cost, quality care. If you have an issue, please let a leadership team member know, and we will be happy to discuss it with you. If you receive an outside referral and do not make an appointment, you will not be eligible to be referred to any outside offices under the affiliation of Community Dental Clinic and it will be the patient's responsibility to find and pay for an office willing to do the treatment. In addition, you risk being dismissed from our clinic.
  • Comply with Clinic Rules. Only patients are allowed in the treatment areas. Patients with special needs may request assistance. Please turn off or silence your phone while in the treatment area. Pictures and videos are not allowed in the office. 
  • We are under no obligation to care for those who choose not to comply with these guidelines.

What to expect in the clinic

  • We work with dedicated volunteer dental professionals from our community who generously give of their time to help those in need.
  • Only patients are allowed in the treatment areas.
  • We ask that each patient be respectful of our volunteers and our staff.  Patients may risk being dismissed from the clinic should their behavior merit the need.


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Built by Community Dental Clinic. THE COMMUNITY DENTAL CLINIC, INC. IS A 501(C)3 NONPROFIT ORGANIZATION: EIN 45-3340613, AND YOUR DONATION IS A CHARITABLE DEDUCTION TO THE EXTENT ALLOWED BY LAW. THE COMMUNITY DENTAL CLINIC, INC. IS REGISTERED WITH THE STATE OF FLORIDA IN COMPLIANCE WITH CH. 496 A COPY OF THE OFFICIAL REGISTRATION AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THE DIVISION OF CONSUMER SERVICES BY CALLING TOLL-FREE (800-435-7352) WITHIN THE STATE. REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL, OR RECOMMENDATION BY THE STATE. 


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