Forms and online resources
Claim form and enrollment form require
Adobe Acrobat Reader. If you don't already have
this program, download
it for free on Adobe's web site.
Delta Dental claim form
Claim
form
Visiting a non-Delta dentist?
Download and print our claim form. Remember, enrollees
don't need a claim form when visiting a Delta
dentist. The dental office files the claim on
their behalf.
Enrollment/change form
View and print the group enrollment/change form.
Dentist directories
Online
directory
Use our online directory
to find a targeted list of dentists based on city
or zip. Use our radius search feature and select
special office features for a more customized
search.
Online benefits and printable
ID card system
Access
our online benefits and eligibility system
Use this system to get an
online benefits summary and to print a personalized
ID card.
Read the FAQ about our online system
Health Fair/Open Enrollment Form
Health Fair/Open Enrollment Form
We have developed a form that allows you to share pertinent details about your event, such as when and where it will be held; types of materials Delta Dental should provide; how many attendees you anticipate; and locations and directions.
