CDBS Check Eligibility

The information you provide will allow us to check if your child is eligible for the $1095 child dental benefits from the federal government.

Date

Childs Name

First Last

Date of Birth

Medicare Card Number

Card expiry date

Childs reference number on medicare card

Parent/Guardians Name

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Mobile Number

Signature

CDBS check eligibility