Wounded Veterans Relief Fund Financial Assistance and Dental Care

Wounded Veterans Relief Fund Financial Assistance and Dental Care is sponsored by Wounded Veterans Relief Fund. The Wounded Veterans Relief Fund offers one-time financial assistance for essential monthly living expenses, including housing, utilities, and childcare, to eligible wounded and disabled veterans throughout Florida.

Apply for Dental Assistance - Putting Veterans First Apply for Dental Assistance Download the Poverty Level Guidelines PDF. Wounded Veterans Relief Fund’s Critical Dental Assistance Program (CDAP) delivers critical, life changing dental care to veterans across Florida through a trusted network of dental providers and strategic community partnerships.

As an approved partner in the Florida Veteran Dental Grant Program, WVRF continues expanding access to care for veterans facing urgent dental needs. If you are seeking assistance, please review and complete the Dental Qualifier Form below. For questions, contact us at dental@wvrf.

org . Thank you for your interest in this life-changing program.

Veteran First Name (Required) Veteran Middle Initial (Required) Veteran Last Name (Required) Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah U.S. Virgin Islands Vermont Virginia Washington West Virginia Wisconsin Wyoming Armed Forces Americas Armed Forces Europe Armed Forces Pacific Service Connected Disability Rating ( % ) (Required) How did you hear about us?

Name of the person who told you about us Referral Agency/Organization who told you about us VA Hospital who told you about us County VSO who told you about us Other way you found out about us General Under Honorable Conditions (Required) Service Connected Oral Injury (Required) Net Annual Household Income ( $ ) (Required) Number in Household (Required) Are you 400% Below Poverty?

(Required) Click here to view the Poverty Level Guidelines PDF Was your last dental visit for a preventive care dental cleaning or for treatment of a dental problem? (Required) When was your last dental care visit?

( Date ) (Required) REQUIRED by all (Required) Authorization to Release Information: I authorize Wounded Veterans Relief Fund (WVRF) to communicate regarding my application, eligibility, treatment coordination, scheduling, case status, and related program matters with the person(s) or organization(s) I designate as my approved representative(s), including but not limited to spouse, family member, caregiver, VA social worker, County Veteran Service Officer, case manager, or referring agency.

I understand WVRF may rely on this authorization unless I revoke it in writing, including by email to Tami Martin, Director of Veterans Dental Program, at dental@wvrf. org. I understand refusal to authorize required communications may delay or prevent services.

By checking this box, I certify that the information I have provided is true and accurate to the best of my knowledge and that I am the applicant or legally authorized representative. Veteran Initials (Required) REQUIRED only if the veterans requires assistance with WVRF programs. Example filling out the application, scheduling appointments, etc..

Authorization for Third Party Communication: I authorize Wounded Veterans Relief Fund (WVRF) to communicate regarding my application, eligibility, treatment coordination, scheduling, case status, and related program matters with the person(s) or organization(s) I designate as my approved representative(s), including but not limited to spouse, family member, caregiver, VA social worker, County Veteran Service Officer, case manager, or referring agency.

I understand WVRF may rely on this authorization unless I revoke it in writing, including by email to Tami Martin, Director of Veterans Dental Program, at dental@wvrf. org. I understand refusal to authorize required communications may delay or prevent services.

By checking this box, I certify that the information I have provided is true and accurate to the best of my knowledge and that I am the applicant or legally authorized representative. First Name of Representative Last Name of Representative Phone Number of Representative I confirm that the above information is true and accurate.