A licensed dentist must complete the examination and sign and date this Proof of School Dental Examination Form. If you are unable to get this required examination for your child, fill out a separate Dental Examination Waiver Form. This important examination will let you know if there are any dental problems that need attention by a dentist.
2019年10月22日 · 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 your child, fill out a separate Dental Examination Waiver Form. This important examination will let you know if there are any dental problems that need attention by a dentist.
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 your child, fill out a separate Dental Examination Waiver Form. This important examination will let you know if there are any dental problems that need attention by a dentist.
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 your child, fill out a separate Dental Examination Waiver Form. This important examination will let you know if there are any dental problems that need attention by a dentist.
PROOF OF SCHOOL DENTAL EXAMINATION FORM To be completed by the parent (please print): State of Illinois Illinois Department of Public Health To be completed by dentist: Oral Health Status (check all that apply) ˜ Yes ˜ No Dental Sealants Present
School Dental Examination form. Each child is required to present proof of examination by a dentist prior to May 15 of the school year. • School dental examinations must have been completed within the 18 months prior to the May 15 deadline. • Each school must give notice of the dental examination requirement to the parents or guardians of
Required for children age 6 months through 6 years enrolled in licensed or public school operated day care, preschool, nursery school and/or kindergarten. (Blood test required if resides in Chicago or high risk zip code.) Questionnaire Administered? No Blood Test Indicated? No Blood Test Date Result TB SKIN OR BLOOD TEST
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 your child, fill out a separate Dental Examination Waiver Form. This important examination will let you know if there are any dental problems that need attention by a dentist.
2024年5月5日 · 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 your child, fill out a separate Dental Examination Waiver Form. This important examination will let you know if there are any dental problems that need attention by a dentist.
Dental Exam Form.pdf - Google Drive
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 your child, fill...