Request Our Services

If you would like someone from the UB School of Dental Medicine to provide services for your school, organization or community, please complete and submit this form.

Our services include:

  • Cleanings
  • Education
  • Examinations
  • Helping identify a dental home
  • Oral cancer screenings
  • Restorations
  • Sealants
Other Questions About Community Outreach?

If you have a general question about community outreach, please email us.

School of Dental Medicine Students, Faculty and Staff


> Use the form for dental school students, faculty and staff

(Required)
(Required)
(Required)
(Required)
What Services Are You Interested In?
What Services Are You Interested In?
 
 
 
 
 
 
 
 
Select All That Apply
What Ages Are The People We Will Be Serving?
What Ages Are The People We Will Be Serving?
 
 
 
 
 
 
Select All That Apply
 
Approximately how many people will we be serving?