Eligibility | The One Smile Research Program

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Operated through the Green Shield Canada

Clinic at the University of Toronto

Thank you for your interest in the One Smile Research Program. Please complete the registration form below so we may assess your eligibility to participate in our program. If your responses match our eligibility criteria and recruitment needs, someone from the research team will contact you within two weeks.

For those registering along with their families, all family members must register individually.

REGISTRATION FORM

First Name

Last Name

Phone

Date of Birth

1. Are you joining along with a family member (living in the same household) or as an individual? *

Family

Individual

2. Have you avoided visiting any dental clinic in the past 2 years because of the cost? This includes any treatment, except emergency care, received in Canada or Internationally. *

Yes

3. Can you read, speak, and understand English? If not, do you have your own interpreter who can accompany you for every session? *

Yes

4. Do you have a valid OHIP card? *

Yes

5. Are you a resident of the City of Toronto or the Greater Toronto Area (GTA) (including Durham, Halton, Peel and York)? *

Yes

Thank you for providing this information. If your responses match our eligibility criteria and recruitment needs, someone from the research team will contact you within two weeks. Please note that a comprehensive screening of eligibility criteria including health conditions and medications will be conducted in person at the research site. During your first visit to the research site you will review consent forms, provide medical and dental history and complete a survey questionnaire. The first visit will take approximately two hours.

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