NJAO Donated Orthodontic Services Program
The New Jersey Association of Orthodontists participates in the New Jersey Donated Orthodontic Services (DOS) program sponsored by the American Association of Orthodontists. The program is designed to help patients who need orthodontic care but cannot afford it.
Participating Orthodontics in New Jersey volunteer to help one or more disadvantaged child who do not qualify for other assistance programs or who are encountering financial distress and cannot obtain needed orthodontic care. No orthodontic fees will be charged to families who qualify.
There are two ways to apply for donated care …
1. Click the application link below
Download and print the Patient Application and mail to: Adam Arellano, Donated Orthodontic Services, 1800 15th Street, Suite 100, Denver, CO 80202. This process takes 4-6 weeks.
2. Call Amalia Dominguez at 720-287-6192 (direct) or 866-201-5906 (toll free) to have an application mailed to you. Fax number is 303-534-5290.
Donated Orthodontic Services Program Eligibility Guidelines
• Patient must be a resident of the State of New Jersey
• Patient must not currently be in braces or in between phases of treatment.
• Patient must have an obvious need for orthodontic treatment significantly affecting dental esthetics or function.
• Patient must be between the ages of 7 & 18; adults will be considered under special circumstances.
• Program applicant must be a patient of record of a family dentist, pediatric dentist or clinic.
• Patient must exhibit and maintain good oral health as determined by the dentist of record.
• Patient or guardian must be willing to adhere to Donated Orthodontic Service rules; the patient must …
a.Have regular dental visits during the course of orthodontic treatment
b.Maintain good oral hygiene
c.Keep all regularly scheduled appointments
d.Take proper care of all orthodontic appliances
e.Comply with all instructions given by the orthodontist
• Patient or guardian must submit their most recent federal (and state) tax returns to the NFDH patient coordinator for income verification. (Below the 200% Federal Poverty Level).
• Patient and guardian/parent must participate in all orthodontic screen and/or interview appointments. (Both the orthodontist and participating family must be comfortable with each other).
• Dentist of record must complete and forward an orthodontic referral form to patient coordinator (Standard Orthodontic Referral slip may be used).
• Patient must be ineligible for orthodontic treatment through insurance or public aid.