Oral Health Assessment Form printable pdf download
Dc Oral Health Form. 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. Web district of columbia oral health (dental provider) assessment form parent/guardian instructions:
Web dc oral health (dental provider) assessment form physical health requirement all participating children must comply with physical health standards set forth by the dc department of health. Web all health suite staff collaborate with school personnel to ensure student health needs are met during the school day. Instructions • complete part 1 below. Please indicate the ward of your home address, list primary care provider, dental provider, and type of dental insurance. Universal health certificate and oral health assessment submission and review process. Web the dc department of health recommends that children 3 years of age and older have an oral health examination performed by a licensed dentist and have the dc oral health assessment form completed. 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. 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 # _______ _______ _______ Student information (to be completed by parent/guardian)
Web dc oral health (dental provider) assessment form physical health requirement all participating children must comply with physical health standards set forth by the dc department of health. Student information (to be completed by parent/guardian) The oral health program within the health care access bureau is responsible for assessing and promoting oral health with an emphasis on access to comprehensive oral health services for all dc residents through a dental home. Web the dc department of health recommends that children 3 years of age and older have an oral health examination performed by a licensed dentist and have the dc oral health assessment form completed. Take this form to the student's dental provider. Web dc oral health (dental provider) assessment form physical health requirement all participating children must comply with physical health standards set forth by the dc department of health. Instructions • complete part 1 below. Part 1:please complete all sections including child’s race or ethnicity. 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: • return fully completed and signed form to the student's school/child care facility.
