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El CENTRO: (760)482-5505

Application

Striving to make our communities a better and healthier place, one smile at a time!

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Eligibility Requirements



We welcome anyone in need to apply for our dental program! Our organization has a non-discrimination policy that ensures it does not discriminate based on race, color, religion, sexual orientation, gender identity, national origin, citizenship status, socio-economic status, age or disability.



Qualifications:

  • Low income
  • No dental insurance
  • Veteran


You must be able to show proof of any of the above qualifications. Please submit the following items (of all household members) to determine eligibility:

  • Filled out SAGE application
  • Valid photo identification
  • Last three months of bank statements
  • Last three months of pay stubs 
  • Previous year's tax forms


Eligibility for our SAGE program is income-based, following the Federal Poverty Guidelines of 2019. Your household income must be at or below the 138% Poverty Level (see values below). 



Household Size                138% FPL Annual Income
_____________________________

1                                            $16,395

2                                           $22,108

3                                           $27,821

4                                           $33,534

5                                           $39,248

6                                           $44,961

7                                            $50,688

8                                           $56,429

9                                           $62,169

10                                         $67,910

11                                          $73,651

12                                         $79,392

Each Additional Person   Add 5,741


                                                SAGE Patient Eligibility Application 2019


                                                                          Click on the link below to download the SAGE Application (English version).

Application 

                       


                                                                         Click on the link below to download the SAGE Application (Español version).

Aplicación