Qualify

1. Patients must be 21 years of age or
older to qualify for treatment.

2. You must live in East Tennessee.

3.You must come to the Keystone Clinic on
Monday, Wednesday or Thursday mornings to apply for
dental treatment.
You may download the needed forms,
print and fill out before bringing them in if you would like.
This will make your time more efficeint.

4. Please bring all proof of income for your household which may include;
gross wages, salary, tips, social security, pension, annuity, veterans benefits
alimony, child support, military family allotment, food stamps and others.
When you bring in your forms; your proof of income must be attached.

IF PROOF OF INCOME IS NOT PROVIDED FOR ALL MEMBERS
IN YOUR HOUSEHOLD, YOUR APPLICATION WILL NOT BE PROCESSED.