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Affordability Assessment Required To Establish Your Payment Plan

To complete your application, we need to confirm you’re able to afford this payment plan.

Payment Plan Affordability Assessment

  • Your Information

  • How To Complete Your Payment Plan Application

    To establish your DentiCare payment plan, DentiCare will need to assess your financial situation to confirm your ability to make consistent payments, we kindly request a manual affordability assessment to evaluate your income, specifically by reviewing your last two pay slips. To proceed, please upload your last two pay slips here.
  • Max. file size: 10 MB.
    The total size of all files for a document upload must be under 10MB. Each file must also be in one of the following formats: pdf png jpeg.
  • This field is for validation purposes and should be left unchanged.
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