Sign Up for your school clinic Online Today

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1. Click on the appropriate download link below (English or Spanish)

2. The form will automatically download for completion or printing when you click the link.
3. Open the downloaded document with the free Adobe Reader (if you don't have Adobe Reader,you can follow the link below to get it free!)
4. Fill out the entire form and save it. (Remember where you saved it!)
5. Return the form to our office via email (office@twentyteeth.org) and be sure to attach the saved form. Be sure it is e-signed if returning via email. 

You can also print, sign and mail it to the address below or fax it to us. 

*** To complete the form on your mobile device you will need the free Adobe Fill and Sign app. This FREE app can be found in your app store.