Apply

The Smiles for Survivors™ Foundation selects qualified breast cancer patients and survivors to undergo necessary dental procedures.
If you are a breast cancer patient or know someone who may be in need of dental treatment, please apply here.

Smiles for Survivors Program Checklist:

• Diagnosed with Breast Cancer AND undergone Chemotherapy Treatment
• Completed Application form (click here to download)
• Reference Letter from friend or family member
• Photo prior to diagnosis
• Current photo
• Medical clearance form from treating physician
• Personal statement detailing your story (250 words) or nomination letter
• Proof of Nevada Residency and Citizenship