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Wholesome Kindness
Application Form
Wholesome Kindness is a pay-as-you-can dental hygiene service for those who need care but may be facing financial challenges. Each month, we offer one limited appointment for a professional hygiene treatment.
This form helps us understand your (or your loved one's) dental needs and situation. If you're applying for someone else, please provide details about their condition and circumstances.
There is no obligation to pay, but contributions help sustain this service. Most importantly, we ask that all applicants commit to brushing twice daily and flossing daily for at least two weeks before their appointment.
No judgment—just care, kindness, and support for a healthier smile. 💙
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