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Dental Forms Library for Employers

Find the application or form that relates to your needs and easily download and print, or submit online.

Authorization Form Granting Access to PHI (PDF, 1 page, 52kb)

Eligibility Enrollment Change Form (PDF, 2 pages, 22kb)
Use this form to submit new adds, changes, and terminations. 

Disabled Dependent Verification Certification (PDF, 1 page, 13kb)
This form officially certifies the dependency status of a disabled dependent. To be signed by the child's physician.