Process for Patients


Referrals must be made online via our referral form by a case worker or shelter manager. We do not accept referrals from individuals.


Using the referral form, the Patient Coordinator assesses the patient’s initial eligibility.  The Patient Coordinator then contacts the patient directly via phone to confirm contact information and provide an overview of Restoring Smiles and its policies and procedures.

The patient is  matched to a Dentist. If the Dentist is male, the patient will be informed. (Note: all patients are asked if they are comfortable seeing a male practitioner. Only patients who have indicated yes, will be matched to a male practitioner.)


The Dentist contacts the patient to set up a short-notice appointment for an examination.  X-rays may be taken (at the Dentist’s discretion) to assess pain.

Please note that patients who miss a screening appointment (and fail to provide notice) will be not be accepted into the program. 

If the Dentist finds the patient’s needs are a fit with the Restoring Smiles program, the patient will be asked to sign the Patient Acceptance Form. The Dentist submits New Patient Examination Forms to the Treatment Coordinator.

The Dentist is the care provider for the patient. The Patient Coordinator will contact the patient to confirm entrance into program, and to share next steps.

The Dentist will create a Treatment Plan for the patient, based on their oral health needs. Patients are only eligible for the treatment outlined in their Treatment Plan.