Dcps Dental Form. Part 1:please complete all sections including child’s race or ethnicity. • return fully completed and signed form to the student's school/child care facility.
benefits.htm
Web health physicals and oral health assessments are required annually. Take this form to the student's dental provider. Schools must verify every student’s immunization compliance as part of enrollment and attendance (see the school immunization policy for more details). Part 1:please complete all sections including child’s race or ethnicity. Amharic (አማርኛ) (link is external) chinese (中文) (link is external) english. Check out how easy it is to complete and esign documents online using fillable templates and a powerful editor. The dental provider should complete part 2. As outlined below, a series of medical forms should be turned in to the school as part of the enrollment process, and any updated forms throughout the school year should be submitted to the school nurse. If the child has no dental provider and is uninsured, For additional information regarding health benefits, please contact our benefits team at dcps.benefits@k12.dc.gov.
• return fully completed and signed form to the student's school/child care facility. • return fully completed and signed form to the student's school/child care facility. Please indicate the ward of your home address, list primary care provider, dental provider, and type of dental insurance. Please indicate the ward of your home address, list primary care provider, dental provider, and type of dental insurance. Child’s personal information part 2. Student information (to be completed by parent/guardian) Web district of columbia oral health (dental provider) assessment form. Please complete all sections including child’s race or ethnicity. As outlined below, a series of medical forms should be turned in to the school as part of the enrollment process, and any updated forms throughout the school year should be submitted to the school nurse. Child’s clinical examination (to be completed by the dental provider)date of exam __________________________ (please use key to document all findings on line next to each tooth) The dental provider should complete part 2.
