Dental Health Form

INSTRUCTIONS: School health professionals review student health information, including dental health, when students enroll in school. When health problems are identified, school health professionals assist students and parents/guardians in accessing appropriate health services, including dental care.

Parent/Guardian: Please complete Section I of this form and ask your child’s dentist or dental hygienist to complete and sign Section II of this form. Return the completed form to the health room at your child’s school.

Help in locating a dentist/dental hygienist may be obtained by contacting the Maryland State Dental Association at www.msda.com. If you do not have access to dental care, please contact the school nurse in your child’s school.

Dental Health Form	41 K	English
Formulario de Salud Dental	44 K	Spanish
Formulaire de Santé Dentaire	40 K	French
Đơn Y Tế Nha Khoa	114 K	Vietnamese
牙齒保健表	76 K	Chinese
치아 건강 양식	53 K	Korean
የጥርስ ጤና ቅጽ	69 K	Amharic

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