Dental Medication Forms - St. Vincent De Paul School
ADVERTISEMENT
1
2+
St. Vincent de Paul
Dear Parent or Guardian:
Our school health program promotes overall health and well-being. We also comply with the requirements of
the State Department of Health. As part of the program parents are encouraged to take their children in for
regular dental examination. When they do so, please have your dentist sign the form or use a form from your
dentist and return it to school: it will become a part of your child’s permanent record. If the form is returned by
st
March 31
your child will not be required to have the school dental inspection.
Report of Dental Examination
This is to certify that I have thoroughly examined the teeth of (full name of patient):
____No dental treatment is necessary at this time.
____All necessary dental treatment has been completed.
____Dental treatment is scheduled.
Date:______________ Signature of Dentist:_____________________________
st
Please return this form as after your child’s appointment and before March 31
.
+
St. Vincent de Paul
Dear Parent or Guardian:
Our school health program promotes overall health and well-being. We also comply with the requirements of
the State Department of Health. As part of the program parents are encouraged to take their children in for
regular dental examination. When they do so, please have your dentist sign the form or use a form from your
dentist and return it to school: it will become a part of your child’s permanent record. If the form is returned by
st
March 31
your child will not be required to have the school dental inspection.
Report of Dental Examination
This is to certify that I have thoroughly examined the teeth of (full name of patient):
____No dental treatment is necessary at this time.
____All necessary dental treatment has been completed.
____Dental treatment is scheduled.
Date:______________ Signature of Dentist:_____________________________
Please return this form as after your child’s appointment and before March 31
st
.
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Medical