Awesome Dental Care for the Elderly in Assisted, Memory Care and Long-term care communities

Long-Term Care resident

Forms

Please CLICK on BOTH LINKS and follow the instructions below.

This form is a REQUIREMENT in the State of Texas.

COMPLETE this form ON-LINE by clicking the box to the left.

This form is a REQUIREMENT if the resident is on Medicaid AND lives in a Long-term care building 

(Nursing facility).

This form is DOWNLOAD only.

Complete, scan and return.