Contact: Chicago Area Louisa Collins PO Box 211 Northbrook, IL 60065 (847) 498-0385 (800) 893-1685 Outside Chicago Marilyn Craig 5407 Norh University Peoria, IL 61614 (309) 689-6785 (800) 699-6785 Sorry, due to a huge back log of  over 1,000 patient applications we are not accepting new applications at this time. Click to open a Donated Dental Services Application for Chicago Area on your desktop or browser using Acrobat Reader. Print this form and mail it today to apply for assistance. Click to open a Donated Dental Services Application for Outside Chicago on your desktop or browser using Acrobat Reader. Print this form and mail it today to apply for assistance.