El centro:760-482-5505

Palm Desert: 760-343-7737

Application

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

LEARN MORE

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
  • Veteran
  • Disabled
  • No insurance
  • No income

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

  • Filled out SAGE application
  • Photo ID/Driver's License
  • Last three months of bank statements
  • Last two pay stubs 
  • Previous year's tax forms


Eligibility for our SAGE program is income-based, following the Federal Poverty Guidelines 2018. Your household income must be at or below the 200% of the Federal Poverty Guideline for your household size (see values below). 


Household Size                200% FPL Annual Income
_____________________________

1                                            $24,120

2                                           $32,480

3                                           $40,840

4                                           $49,200

5                                           $57,560

6                                           $65,920

7                                            $74,280

8                                           $82,640

                                    SAGE Patient Eligibility Application 2018


                                                                        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