FREE Dental Services
Provided by NM Smiles GO on the campus of Jemez Valley Public Schools.
· ALL students of Jemez Valley Public Schools are eligible and encouraged to participate.
· No income requirements.
· Dental services provided are FREE.
o
Please provide
your student’s Medicaid or dental insurance information on the permission form
for billing purposes.
o
Parent/Guardian
will NOT receive a bill and will NOT have a copay.
o
If your student
does not have Medicaid or dental insurance please initial the permission form
for a free dental exam.
· Dental Services Permission Form is REQUIRED.
o
Services cannot
be provided without a completed form.
o
Please complete
and return the form to the school.
· Dental services included:
o
Exam
o
Cleaning
o
If needed,
§ X-Rays
§ Fluoride - NEW
fluoride available for major tooth decay that helps prevent further decaying
while the individual waits to receive services.
§ Sealants
§ Small fillings WITHOUT anesthetic
§ Referral for other services
·
Questions, please contact the
nurse, (505) 842-0902 ext 308 or (575) 834-7391 ext 308.
DOWNLOAD THE PERMISSION FORM