Dcps Dental Form. Part 1:please complete all sections including child’s race or ethnicity. Check out how easy it is to complete and esign documents online using fillable templates and a powerful editor.
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Part 1:please complete all sections including child’s race or ethnicity. All employees are eligible for dental and vision options outlined in the dental/optical section below. Student information (to be completed by parent/guardian) Take this form to the student's dental provider. Child’s personal information part 2. Web district of columbia oral health (dental provider) assessment form parent/guardian instructions: 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) Please indicate the ward of your home address, list primary care provider, dental provider, and type of dental insurance. For additional information regarding health benefits, please contact our benefits team at dcps.benefits@k12.dc.gov. 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.
Please indicate the ward of your home address, list primary care provider, dental provider, and type of dental insurance. Amharic (አማርኛ) (link is external) chinese (中文) (link is external) english. Web district of columbia oral health (dental provider) assessment form. Please indicate the ward of your home address, list primary care provider, dental provider, and type of dental insurance. Web health physicals and oral health assessments are required annually. Please indicate the ward of your home address, list primary care provider, dental provider, and type of dental insurance. Web universal health certificate use this form to report your child’s physical health to their school/child care facility. 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) Take this form to the student's dental provider. Child’s personal information part 2. • return fully completed and signed form to the student's school/child care facility.
