Forms and online resources

Claim form, enrollment forms and regional dentist directories require Adobe Acrobat Reader. If you don't already have this program, download it for free on Adobe's web site.

Delta 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.