Do you want to collaborate with us?

Bring us your deciduous teeth, and we will exchange them for a gift and a diploma.
Please, fill in the forms below with as much information as possible. The more accurate it is, the more it will help us! If the tooth has been extracted and/or if you have participated in previous campaigns, tick the corresponding box. If you know the exact date the tooth fell out, great! If not, the age of the donor at the time of tooth loss is also very useful.
Finally, the parent or legal guardian must sign the document that has to be enclosed when handing over the tooth. Don't forget to read everything carefully.

Thank you for helping us to continue our research!

There are two ways to provide information:
In person If you are coming in person to hand in your tooth, download this form: Printable version for hand delivery Online If you will not be able to come in person to deliver the tooth, please fill in the following fields so that we can receive the information electronically. You will receive a confirmation email.
Donor information
Other donor information*

*If you are not sure, please write "unknown" in the field




Paternal grandfather

Paternal grandmother

Maternal grandfather

Maternal grandmother

*If you are not sure, please write "unknown" in the field

Other donor information*

Add the age and date of loss for each donated tooth

*If you are not sure, please write "unknown" in the field

Before sending the form...

We will only use your email address if necessary to formalize this donation and will not use it for any other purpose.
Please include your details as parent/legal guardian if you are filling in the form on behalf of a minor. In any other case, please fill in your full name and ID number.
Please download the consent form below and sign it. We need your consent for the processing of parts and data.