Get Dental Exam Form

Completing the Dental Exam Form online is a straightforward process that ensures your child's dental health information is accurately recorded. By following these detailed instructions, you can easily navigate each section and ensure all necessary information is submitted efficiently.

Follow the steps to fill out the Dental Exam Form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering your child's name in the designated fields for last name, first name, and middle name. Follow this by providing their birthdate using the month, day, and year format.
3. Enter your address by filling in the street, city, and zip code fields to ensure proper identification of your location.
4. Include your home telephone number to facilitate communication as required.
5. Indicate the center name where your child is enrolled and their class to provide context for the dental exam.
6. Provide the name of the parent or guardian completing the form, ensuring accurate representation.
7. Select your child's gender from the options provided: male or female.
8. Next, the dentist will complete their portion. Ensure that they check all relevant boxes regarding oral health status, including dental sealants, caries experience, untreated caries, soft tissue pathology, and if the child received cleaning and prophylactic fluoride treatment in the past six months.
9. Dentists should assess and indicate any treatment needs such as urgent treatment, restorative care, preventative care, and any other specific needs.
10. Record the date of the next appointment as specified by the dentist.
11. Finally, ensure the dentist signs the form, providing their name and date of examination, along with their address and telephone number.
12. Once all sections are filled out accurately, review the form for any errors. You can then save changes, download, print, or share the completed form as needed.

Take the first step towards ensuring your child's dental health by completing the Dental Exam Form online today.