Eligibility

VINA has a limited amount of openings for patient eligibility. Applications will be accepted by appointment only. Please contact VINA Dental at (810) 844-0240, Monday-Thursday 9:00 am-4:00 pm. Applications can be picked up at the VINA Community Dental Center during business hours at 400 E. Grand River Ave., Brighton, MI 48116 or printed from our website here.

Eligibility: Patients must meet ALL FOUR requirements:

  1. Individuals must live in Livingston County for at least 6 months
  2. Individuals must be at least 18 years of age
  3. Must have NO dental insurance
  4. Families must have an income at or below 225% of the federal poverty level. This also includes public assistance, social security, and unemployment. EFFECTIVE 5/17/2022: Income can be up to 250% of the Federal Poverty Level. Changes are reflected in the chart below.
Family SizeFPL (100%)VINA Eligibility (250%)
1$14,580$36,450
2$19,720$49,300
3$24,860$62,150
4$30,000$75,000
5$35,140$87,850
6$40,280$100,700
7$45,420$113,550
8$50,560$126,400

If you do not qualify for VINA, please click here to find more options for affordable dental care near you.

Services Provided*:

  • Exams including oral cancer
  • Cleanings
  • Fillings
  • X-rays
  • Fluoride Treatments
  • Oral Surgery/Extractions
  • Dental Education Materials
  • Crowns
  • Nightguards

*Note: In general, Root Canals and Periodontal services are provided on a limited basis and alternatives may exist that may not be provided within the scope of this clinic.

Services NOT Provided:

  • Braces
  • Whitening
  • Cosmetic Dentistry
  • Sedation – IV or oral
  • Nitrous Oxide (Laughing Gas)
  • Implants

Application Procedures:

  • Applications are accepted on a daily basis
  • Patients must complete the Eligibility Forms. You can print them to fill them out by hand, or fill them out electronically at the bottom of this page.
  • Patients will be required to pay a scheduling fee of $25.00 for each visit.
  • All appointments must be PREPAID
  • Patients must bring proof of residence in Livingston County (ie: utility bill, etc.)
  • Patients must bring proof of family income (ie: last year’s tax return, unemployment statement, or social security statement)
  • Patients must bring a Michigan photo ID

Important Information:

  • Update proof of “Family Income” (including spouse) and residence once per year.
  • Patients must arrive 15 minutes BEFORE every appointment
  • If patient misses an appointment, co-pay will not be reimbursed and patient will be put at the END of the wait list after another payment is made.
  • In the event of inclement weather, if Brighton Area Schools are closed, VINA will also be closed.

Children:

  • Children may not be left alone in waiting room and must be supervised at all times.

Submission:

Please complete the Patient Eligibility Paperwork below. Applications are accepted by appointment only. Please call the office to setup screening appointment.

If filling out online: Once you have finished it, download it to save your changes and then send the downloaded copy (with your information) to Clinic Director Alicia Branstrom (abranstrom@vinadental.org).

Click here to download the online/fillable eligibility form

If printing and completing: Please mail or drop off your completed application to VINA at 400 E. Grand River Ave., Brighton MI 48116.

Click here to download the printable eligibility form