Dc oral health assessment form Fill out & sign online DocHub
Dc Oral Health Form. Web oral health assessment form. Web instructions • complete part 1 below.
Dc oral health assessment form Fill out & sign online DocHub
Web instructions • complete part 1 below. Part 1:please complete all sections including child’s race or ethnicity. Universal health certificate and oral health assessment submission and review process. Child’s clinical examination (to be completed by the dental provider)(please use key to document all findings on line next to each tooth) tooth # tooth # tooth # tooth # _______ _______ _______ Web district of columbia oral health (dental provider) assessment form parent/guardian instructions: Take this form to the student's dental provider. Web oral health assessment form for all students aged 3 years and older, use this form to report their oral health status to their school/child care facility. Child’s personal information part 2. This form replaces the dental appraisal form used for entry into dc schools, all head start programs, childcare providers, camps, after school programs, sports or athletic participation, or any other district of columbia activity requiring a physical examination. The dental provider should complete part 2.
Web oral health assessment form for all students aged 3 years and older, use this form to report their oral health status to their school/child care facility. The dental provider should complete part 2. Web all health suite staff collaborate with school personnel to ensure student health needs are met during the school day. Tb case report form [pdf] vital records Student information (to be completed by parent/guardian) Instructions • complete part 1 below. Universal health certificate and oral health assessment submission and review process. Take this form to the student's dental provider. Web oral health assessment form for all students aged 3 years and older, use this form to report their oral health status to their school/child care facility. This form is a confidential document. Web oral health assessment form.
