DWP Kids Forms and Resources
Delta Dental of Iowa makes it easy for you to work with us. Click on the links below to view the document you need.
- DWP Kids Member Handbook
- Member Benefits Flyer
- Member Rights & Responsibilities - This describes your rights and responsibilities as a member.
- DWP Kids Privacy Policy – This describes how health information about you may be used and disclosed and how you can get access to this information.
- Personal Representative Appointment and Authorization to Release Protected Health Information – This form allows Delta Dental of Iowa to disclose protected health information at your request.
- Financial Responsibility Consent for Treatment – This describes that you understand if you need to pay for any services that are not covered by DWP.
- Grievance and Appeal Process – This describes the process to go through if you are not happy about any part of the Dental Wellness Plan.
- Member Complaint Form – This can be used to file an official complaint with DWP.
- Member Appeal Form – This can be used to request an appeal of a benefit decision.
- Exception to Policy Form - This can be used to submit an exception to policy for DWP.
- Preventing Fraud, Waste and Abuse - This can be used to explain ways to prevent Fraud, Waste, and Abuse. To learn more, watch an informational video.