Dental Care Coordination Referral Instructions

For Medical Providers

To refer your patients 0-5 on Medi-Cal Managed Care for dental care coordination, please complete and submit the following Dental Care Coordination form.  Downloadable here or in the Resources page under the "Care Coordination Materials" section.  Please fax the completed forms to:  (415) 581-2327 within 5 business days of service.  

Eligibility

All children ages 0-5 years old (up to 6th birthday) with Medi-Cal are eligible to receive dental care coordination either through the DTI project or through the San Francisco CHDP Program.  

If you have questions about your patient's eligibility to receive dental care coordination, please feel free to contact us for more details.  

​San Francisco Dental Transformation Initiative
Local Dental Pilot Project
30 Van Ness Avenue, Suite 260B
​San Francisco, CA 94102