1. Make an Appointment Online

Please note that this is only a request for an appointment. We’ll contact you to confirm the appointment. Thank you for choosing UCHC’s Dental Program for Kids! By clicking the “Request an Appointment” button you agree to the Terms & Conditions below.

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For appointments or questions, call our clinic at 520-407-5617

2. Registration

You may Download the registration form and fill it out manually. New electronic forms will be coming soon!

Thank you for your patience, we are updating our website and we currently cannot accept online registrations. Please reach us at (520) 407-5617 or dental4kids@uchcaz.org to make an appointment.

To fill out a registration packet you may download (English)(Spanish) and fill out information to bring to your first appointment or you may fax to (520) 882-3255.

Download Our Registration Packet

1. Even if your child has been seen in our dental program, please fill out the Registration Form, parts 1– 6. Registration Forms MUST BE FILLED OUT ANNUALLY.

2. If your child has not been seen in our program, please fill out Parts 1-6 (front and back) on the Registration Form.

3. Please fill out the Demographic Form (all information is kept confidential)

4. Don’t forget to sign where indicated!

5. Keep the Patient Rights and Responsibility page for your records.

6. Return completed Registration Forms to your school nurse.

**Please note Incomplete Registration Forms will delay your child’s exam.

Dental Program for kids Green Valley registration form

En español

Dental Program for kids Green Valley registration form - spanish

For appointments or questions, call our clinic at 520-407-5617

3. Parent Guidelines

Your child’s comfort and safety are our priority during dental treatment. Many children do better with their caregivers waiting in the lobby rather than accompanying them to the treatment room. This allows them to build a strong relationship with the dental team.

There are a couple of things to keep in mind to help your child do well with any dental appointment:

  1. Be careful about what you and others say.Children respond to their caregivers’ words. We encourage you to portray the dental office as a fun place. Please don’t let anyone tell your child horror stories about dental offices, even in “fun.” Please don’t use words like “shot,” “drill” or “yank.”
  2. Be supportive of the care we are providing your child.If you feel anxious about your child’s dental care please speak with the doctor outside of the treatment room, away from your child. Children often do much better with dental care than most parents expect.
  3. If a dental team member asks for you to wait in the lobby or to sit down, please do so immediately.Sometimes children will act uncooperatively to try to control a situation. They may have had previous experience when they acted uncooperatively and they were removed from that situation. We find that many children do better once their parent has left the treatment room.
  4. Please offer silent support.Children will often listen to their parent’s voice above all others so hearing your familiar voice will be a distraction for them. They will also repeat the behavior to hear your voice again.

Here are a few words that can make your child more at ease when speaking to them about upcoming appointments:

Don't Use

Needle or Shot
Drill a Tooth
Pull or Yank Tooth
Decay, Cavity
Tooth Cleaning
Rubber Dam

Instead, We Recommend

Sleepy Juice
Power Scrubber
Clean a Tooth
Wiggle a Tooth Out
Sugar Bug
Count Teeth
Tickle Teeth
Tooth Counter
Happy, Magic, or Astronaut Air