
GRANT APPLICATION FOR LOUISIANA DENTISTS AFFECTED BY DISASTER
(for property damage only)
Application deadline: The end of the period of time in which a State of Emergency related to the disaster is declared to be in effect by the state of Louisiana.
This online application will be submitted automatically once you complete all pages.
Fax additional documentation to 225-926-1886 or e-mail to tisha@ladental.org
Note: Documentation should include a maximum of 3 photos (email is acceptable). Photos can be emailed to tisha@ladental.org. Documentation CAN include an adjustor’s report, a detailed description of the items damaged/lost/destroyed or a combination. Grants are based on financial availability of funds through the LDA Foundation.
Pleases provide your temporary contact information:

5637 Bankers Ave., Baton Rouge, LA 70808
We are sorry to hear about the damages sustained. We have received your grant application and will be in touch as soon as possible. Until then, should you have other questions or needs, contact us at
tisha@ladental.org,
info@ladental.org, (225) 926-1986, (800) 388-6642, or
www.ladental.org.
Please submit your photos to
tisha@ladental.org. This documentation should include a maximum of 3 photos.