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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 Take this form to
PROOF OF SCHOOL DENTAL EXAMINATION FORM To be completed by the parent please print To be completed by dentist Oral Health Status check all that apply Yes
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Top 9 Dental Exam Form Templates Free To Download In PDF Format
Top 9 Dental Exam Form Templates Free To Download In PDF Format
School year A licensed dentist must complete the examination sign and date this Proof of School Dental Examination Form If you are unable to get this required examination for
School Dental Examinations All Illinois children in kindergarten Grade 2 Grade 6 and Grade 9 are required to have an oral health examination This is required for all public
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FREE 9 Sample Dental Examination Forms In PDF Word
FREE 9 Sample Dental Examination Forms In PDF Word
The school year A licensed dentist must complete the examination sign and date this Proof of School Dental Examination Form If you are unable to get this
PROOF OF SCHOOL DENTAL EXAMINATION FORM To be completed by the parent please print Student s Name Last First Middle Birth Date To be completed by
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PROOF OF SCHOOL DENTAL EXAMINATION FORM To be completed by the parent please print To be completed by dentist Oral Health Status check all that apply Yes
https://www. cdph.ca.gov /Programs/CCDPHP/DCDIC/CD…
Oral Health Assessment Form California Department of Public Health July 2021 Page 1 of 2 Oral Health Assessment Form California law Education Code Section 49452 8
PROOF OF SCHOOL DENTAL EXAMINATION FORM To be completed by the parent please print To be completed by dentist Oral Health Status check all that apply Yes
Oral Health Assessment Form California Department of Public Health July 2021 Page 1 of 2 Oral Health Assessment Form California law Education Code Section 49452 8
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