Would you like to become an independent sales representative for American Dental Care?
If so, simply fill out both Agreement PDF and W-9 PDF below:
After both forms are filled out, please send by
This plan is not insurance. The plan provides discounts at certain health care providers for medical services.
The plan does not make payments directly to the providers of medical services. The plan member is obligated to pay for all health care services but will receive a discount from those health care providers who have contracted with the discount plan organization.