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Applications for
Dental Services
Medicaid
Eligible Children (ages 3-19):
Parents or legal guardian, please print and complete the documents below and return
to the Jefferson County Health Department-Arnold Branch. Upon receipt of all completed
forms, you will be contacted to set up a dental appointment.
Uninsured Children (ages 3-19):
Parents or legal guardian, please print and complete the documents below
and return to the Jefferson County Health Department-Arnold Branch. Upon receipt
of all completed forms, you will be contacted to set up a dental appointment. Applications
will not be considered if no proof of income is received. To see if you qualify,
please refer to sliding scale fee.
Adults (Ages 20 and Up):
Unfortunately, we do not offer dental services for adults at this time; please see
Clinic Referrals for assistance. (Link to clinics)
Return All Forms To:
Jefferson County Health Department-Arnold Branch
Attn: Dental Clinic
1818 Lonedell Road
Arnold, MO 63010
Click for Forms
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