Florida Healthy Kids Incentive Form

To get your $10 Amazon gift card you must:

Please briefly explain your license request below

While showing active coverage, make sure to have the qualifying dental services:

Members age 6-14 years I had a sealant

Date of service

I registered for the DentaQuest member portal Yes

Member Information

First Name

Last Name

Date of Birth

Phone

Mailing address

City

Zip code

If you have questions, please call DentaQuest toll free 888-696-9557 TTY 711 or 800-855-2880.

Un boletín informativo con consejos e información para mejorar su salud bucal.