State Of Illinois Proof Of Dental Examination Form

State medical examination form (Los Angeles) in Word and Pdf formats

State Of Illinois Proof Of Dental Examination Form. Web proof of school dental examination form illinois law (child health examination code, 77 ill. Web this is required for all public, private, and parochial schools.

Web the state of illinois requires that all students in kindergarten, second, sixth and ninth grades have an oral health examination performed by a licensed dentist. Code 665) states all children in kindergarten and the. 601 4/2007 proof illinois of school department dental of examination public health form to be completed by the parent (please print): If you are unable to get this required examination for your. Web proof of school dental examination form to be completed by the parent (please print): Web proof of school dental examination form illinois law (child health examination code, 77 ill. Am unable to obtain the. Oral health status (check all that apply) £ yes. My child is enrolled in the free and reduced lunch program. Web proof of school dental examination form.

601 4/2007 proof illinois of school department dental of examination public health form to be completed by the parent (please print): Examinations must be performed by a licensed dentist, and he/she must sign the proof of school dental. For head start agencies, please also list appointment date or date of most recent treatment completion date. Web a licensed dentist must complete the examination, sign and date this proof of school dental examination form. If you are unable to get this required examination for your. Web proof of school dental examination form to be completed by the parent (please print): To be completed by dentist:. Oral health status (check all that apply) £ yes. Am unable to obtain the. Web this is required for all public, private, and parochial schools. Web proof of school dental examination form.