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Volunteer Registration Form
Thank you for your interest in volunteering at the Northern Virginia Dental Clinic! Please use the form below to volunteer your valuable time and skills to patients in need.
About NVDC:
The Northern Virginia Dental Society (
NVDS
) supports the Northern Virginia Dental Clinic (
NVDC
), which provides oral health care services to low-income residents in the Northern Virginia region with access at its facilities in Fairfax and Loudoun. The NVDC accepts only those individuals deemed eligible through an established network of referring social service agencies. Emergency and initial appointments must be scheduled through designated referring agencies only. Individuals must be age 18 or older and individual/family income must be at or below 200% of the federal poverty guidelines.
To be eligible, the patient must be a resident of Arlington County, Fairfax County, Loudoun County, City of Alexandria, City of Fairfax, or the City of Falls Church.
Visit the NVDC website at
https://www.novadentalclinic.org/
to learn more.
First Name
*
Middle Initial
Last Name
*
Preferred Email
*
🛈
Preferred Phone Number
🛈
Position
*
Dentist
Dental Hygienist
Other (please describe)
Other (please describe)
The clinic can accommodate your availability and scheduling preferences. Patients are appointed at 45 minute intervals with extended hours until 8:00 pm on Tuesdays and Thursdays (Fairfax location only).
NVDC-Fairfax
8221 Willow Oaks Corporate Drive, #405
Fairfax, VA 22031
* Mon, Wed, and Fri (8:30 AM – 5:30 PM)
* Tue and Thu (8:30 AM – 8:00 PM)
NVDC-Sterling
2 Pidgeon Hill Drive, #230
Sterling, VA 20165
* Mon–Fri (8:30 AM – 5:30 PM)
Preferred Clinic Location
*
NVDC - Fairfax
NVDC - Sterling
No Preference
When are you
generally
available to volunteer at the clinic?
AM (8:30-11:30 am)
PM (1:30-5:00 pm)
All-Day
Mon
AM (8:30-11:30 am)
PM (1:30-5:00 pm)
All-Day
Tue
AM (8:30-11:30 am)
PM (1:30-5:00 pm)
All-Day
Wed
AM (8:30-11:30 am)
PM (1:30-5:00 pm)
All-Day
Thu
AM (8:30-11:30 am)
PM (1:30-5:00 pm)
All-Day
Fri
AM (8:30-11:30 am)
PM (1:30-5:00 pm)
All-Day
Enter any details about your expertise or related experience, or any questions about the NVDC volunteer program.
If you are ready to submit your volunteer form, click the button below.
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