Free Dental Sealant Permission Slip Form
Multnomah County School Dental Sealant Program
503-988-3905

¿Necesitas ayuda? ¿Tiene preguntas? Llamenos al 503-988-3905

Нужна помощь? Есть вопросы? Позвоните нам по
503-988-3905
Your child's school has been chosen to participate in the Multnomah County School Dental Sealant Program. Dental Sealants are coatings put on the back of the teeth, and are a quick and easy way to prevent cavities. The screening, sealants and follow up care are FREE, and done by dental care professionals.
Name of Student: (Last, First, Preferred name)
Student's Date of Birth (mm/dd/yy)
Teacher
You child's grade
School
Next
Never submit passwords through Google Forms.
This form was created inside of Multnomah County. Report Abuse