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Interest in Sharing Your Dental Story

Thank you for your interest in our project. Your answers will help us see if you qualify for the next step—sharing your dental care story with our team.

Maryland Dental Action Coalition (MDAC) is looking to learn about how the Medicaid’s Maryland Healthy Smiles Dental Program is helping adults get the dental care they need. The information you share will help us understand how dental coverage works and how it can be improved. With your permission, some stories may be shared with lawmakers to help make dental care better for everyone.

Your answers will be private and anonymous — we will not share your name or anything that can identify you. Taking this survey will not affect your Medicaid benefits in any way.

By continuing, you agree to take part in this survey voluntarily. You can skip any questions you don’t want to answer and stop at any time.

If you have questions, please email MDAC at info@mdac.us

Let’s get started!
1.What is your age?
2.Are you currently enrolled in Maryland Medicaid?
3.If you are a female, are you currently pregnant? If you are not female, please skip this question.
4.If you are a female, have you given birth within the past 12 months? If you are not female, please skip this question.
5.Have you received any dental care through Maryland Medicaid or the Maryland Healthy Smiles Dental Program since January 1, 2023?
6.How would you prefer to share your dental care story? (Select all that apply)
7.Your Contact Information

We will use your contact information only to follow up about next steps in learning about your story.
8.What is your preferred method of contact?