Dc Oral Health Form. The dental provider should complete part 2. Web oral health assessment form.
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Please indicate the ward of your home address, list primary care provider, dental provider, and type of dental insurance. Student information (to be completed by parent/guardian) 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. Part 1:please complete all sections including child’s race or ethnicity. Instructions • complete part 1 below. 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. Take this form to the student's dental provider. 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 # _______ _______ _______ 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 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. Part 1:please complete all sections including child’s race or ethnicity. 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 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. Universal health certificate and oral health assessment submission and review process. Web instructions • complete part 1 below. • return fully completed and signed form to the student's school/child care facility. 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 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. Instructions • complete part 1 below. The dental provider should complete part 2.
