Wufoo
Smile Guardian Contact Form
Help up to 1,000 underserved kids protect their smiles!
Many kids do not have access to the basic tools and oral health education necessary to maintain good dental health.
You can be an Official Smile Guardian for these vulnerable kids. Focusing on prevention, this initiative of America's ToothFairy helps equip kids and their families with the information and basic tools they need to protect their smiles and prevent tooth decay by distributing Protect Your Smile Resource Kits to schools, nonprofit dental clinics or community organizations that serve kids in need.
Please provide your contact information below to learn more:
Title
Dr.
Name
*
First
Last
Email
*
Dental Practice / Company Name (optional)
Phone Number (optional)
###
-
###
-
####
City
State
I would like more information about the following donation level:
*
$200/month (oral heath education for 1,000 kids annually)
$100/month (oral heath education for 500 kids annually)
$50/month (oral heath education for 250 kids annually)
A one-time donation of $100 (oral health education for 50 kids)
I'm not sure yet.
How did you hear about the Smile Guardian initiative?
America's ToothFairy website
Social Media post
Online Get Involved Tool
Email from America's ToothFairy
Friend/Colleague
Other
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