Get Oral Health Assessment/waiver Request Form - Glendale Unified ...

Completing the Oral Health Assessment/Waiver Request Form for Glendale Unified School District is essential for your child's dental health requirements. This guide provides clear and structured steps to assist you in filling out the form online, ensuring a smooth process.

Follow the steps to successfully complete the form.

1. Click the ‘Get Form’ button to access the form and open it in the online editor.
2. In Section 1, provide your child's information. Fill in their first name, last name, middle initial, birth date, address, apartment number, city, ZIP code, school name, teacher's name, grade, and gender.
3. Complete the child’s race/ethnicity by checking the appropriate boxes that apply from the provided list.
4. For Section 2, this section is meant to be filled out by the dental professional after the oral health assessment. If applicable, wait until the dental professional records their findings including the assessment date and treatment urgency.
5. In Section 3, if you need to request a waiver for the oral health assessment requirement, check the box that best describes your reason. You can specify additional reasons in the optional space provided.
6. Once all sections are completed to your satisfaction, ensure to sign and date the form as the parent or guardian.
7. Finally, save your changes, and choose to download, print, or share the form as needed.

Complete the Oral Health Assessment/Waiver Request Form online today to ensure your child meets the health requirements for school!