Apply for Assistance

Information & Application

To Qualify for Assistance:

  • Child must reside in San Juan County, New Mexico.
  • Child must be under age 18.
  • Application form must be completed.
  • Referral from a provider is required.
  • Proof of out of town appointment required.
  • Assistance is limited by available funds.


* We do not provide assistance for treatment that is available in San Juan County, New Mexico. We do no assist with routine well child and/or dental visits.

Application for Assistance