Your child/children’s school may require you to provide a completed Student Oral Health Form for entry into Pre-K/Kindergarten and 2nd, 7th and 12th grades.

If your child is a current patient of our practice, please ask us at your next dental visit to complete this form for you. If you require the form prior to your next visit, please fill out the following request form and we will mail the completed form to you or you can pick it up from our office.

School forms will only be completed for ACTIVE patients that have been seen by Dr. Patnoe within the last 12 months.

Please note: to protect your privacy, you must either pick up the completed form(s) in-person or we will mail it/them to you. We will not email or fax completed Student Oral Health Forms to you.