Follow the steps to complete the consent form online.

1. Click ‘Get Form’ button to acquire the form and open it in the digital editor.
2. Begin by entering your child's name in the designated field, followed by their birth date and current grade. This information is critical for identifying your child.
3. Indicate your child's gender by selecting either Male or Female. Complete all fields carefully to avoid any delays.
4. Provide a contact phone number where you can be reached.
5. Fill in the teacher's name and the school your child attends to ensure the dental services are administered at the correct location.
6. Complete the address fields, including street address, city, and ZIP code, to provide necessary location information.
7. In the insurance information section, select the appropriate option regarding your child's insurance coverage (Medicaid, Private Dental Insurance, or Uninsured) and fill in the corresponding details.
8. Next, answer the health history questions by checking any serious health problems that your child may have experienced, listing any allergies, and noting current medications.
9. Indicate if your child experiences any dental pain, and if yes, provide additional information regarding the duration.
10. If your child is currently seeing a dentist, please list their name and the date of the last visit.
11. As a parent or legal guardian, sign the consent to confirm authorization for dental services, print your name, enter the date, and specify your relationship to the child.
12. Finally, review all entered information for accuracy. Once confirmed, save your changes, and opt to download, print, or share the completed form as necessary.

Start completing your MS MHS Mobile Dental Screening Consent Form online today.