Plan Enrollment

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Enrollment in the Twin Dental Wellness Plan is easy.

  • Give us a call and schedule your Twin Dental Wellness Plan New-Patient Appointment for you and your participating family members. Or, if you have questions, complete the form below and ask our office to call you to schedule your appointment.
  • Complete the online enrollment form below. Or, click here to download a fillable form and email it to [email protected].
  • Visit our office for your New-Patient Appointment and enroll in person. Enrollment fees will be due at the time of service.

Enrollment Form

    Primary Participant Information


    Plan Participants





    I agree to all terms of this plan and agree to enroll