Fire Efforts Subsidies

Name

First Last

Email

Mobile Number

Are you:

Please provide information about how you were affected by the fires, whether you have suffered an injury or incurred personal or capital loss?

hat was your role: firefighter, community service, volunteer, animal welfare Please provide information about your involvement in the fire recovery effort.

Did you receive payment or wages for your work? If yes, what percentage of your contribution was volunteered?

Please indicate what dental treatment you require?

Have you received a quote for your required treatment, and if so what was the cost of the proposed treatment?

I agree to be contacted by a representative of All-On-4 Clinic to discuss my situation

I Agree

After Submit: Thank you for reaching out. Your application has been placed in a queue and will be considered for cost subsidies. If your matter is urgent please contact Taryn social@allon4.com.au or call 03 8845 5400 to make an appointment.

Fire Efforts Subsidies

Happiness begins with a smile™

1300 255 664

Fire Efforts Subsidies

Fire Efforts Subsidies

Happiness begins with a smile™

phone 1300 255 664

1300 255 664