Membership Renewal

Renew your membership ONLINE. Click here to renew NOW!
The Vermont State Dental Society values each and every one of its' members. We would encourage you to call our Membership Manager, Diane Dumas, and speak to her directly, at 802-864-0115, as many situations with membership are so unique. To get a head start, fill out the ADA/VSDS Membership application below. All applications should be submitted to:

Vermont State Dental Society
1 Kennedy Drive, Suite L3
South Burlington, VT 05403 

802-864-0116 (fax) 

Member Dentist Profile Update

The information in this form will be used for the VSDS Membership Directory.  In the dentist information section, the dentist's preferred email should be used (not automatically the general office email).  Please complete all fields.  

Office Name & Address:

Dentist Name & Dentist Preferred Email:

(if staff completes, please ask dentist for preferred email)

Office Manager Name & Email

Please note that this will serve as a secondary contact for the VSDS.

​Patient Care Services You Provide

Pain management used in your office:

Are you accepting NEW adult medicaid patients?

Are you accepting NEW child medicaid patients?

Select any of the following services used in your office.