Help Us Help Veterans!

Dear Doctor,

Thank you for participating in the Smiles in a Box Veterans Program! Your time is greatly appreciated. In order to evaluate this programs impact, we ask that you fill out the following form at each veteran’s office visit.

  • Number of teeth
  • Degree of plaque
  • Severity of gingival inflammation
  • Number of 4mm pockets or greater
  • Estimated number of sites with bleeding upon probing (BOP)

Please visit to complete.