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. If you require the form before your next visit, please fill out the following request form, and we will mail or fax the completed form to you, or you can pick it up from our office.
DUPLICATE FORM CHARGES
Please note we provide Student Oral Health Forms one time each school year per patient. You will be charged $20.00 per patient for duplicate records.
School forms will only be completed for ACTIVE patients seen by Dr. Patnoe within the last 12 months.