200 River Place, Monona, WI 53716

- Survivors of domestic or sexual violence, age 18 and older. - Dental injuries to the smile-zone from former partner or spouse, family member, or sexual violence. - Applicant must be away from all abusive relationships/situations for at least 1 year. - Must meet with a DV/sexual assault advocate, case manager, counselor, therapist, or doctor with experience in counseling survivors of domestic violent/sexual assault, at least once.

$20 application fee (which is paid online at the completion of the application) or 10 hours of completed community service in lieu of application fee. Community service must have been performed within 12 months of the date of application. If approved for the program, dental services are free.