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[DOC File]Oral Health Assessment Form - Health Services & …
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California Department of Education. March 2008. Page 1 of 1. Oral Health Assessment Form. California law (Education Code Section 49452.8) states your child must have a dental check-up by May 31 of his/her first year in public school. A California licensed dental professional operating within his scope of practice must perform the check-up and fill out Section 2 of this form. If your child had ...
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[DOC File]Student health Support Plan - Department of …
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The school collects personal information so as the school can plan and support the health care needs of the student. Without the provision of this information the quality of the health support provided may be affected. The information may be disclosed to relevant school staff and appropriate medical personnel, including those engaged in providing health support as well as emergency personnel ...
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[DOC File]PRINCIPLES, STANDARDS, AND GUIDELINES - …
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2000-10-02 · The sponsoring agency shall be a non profit public or private institution locally suited and fiscally viable to administer and operate a Health Center serving the needs of adolescents (i.e., health center, hospital, medical school, health department, youth serving agency, school or school system). Non medical agencies must contract the medical component with a qualified medical provider; the ...
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[DOC File]School Dental Form - Department of Health Home
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Title: School Dental Form Author: sweigle Last modified by: Lpavlesich Created Date: 12/9/2008 3:31:00 PM Company: Pennsylvania Department of Health
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[DOC File]Health Screening Form - Arkansas Department of …
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Arkansas Department of Human Services. Division of Child Care and Early Childhood Education. To Parent or Guardian: In order to provide the best learning experience for your child, teacher must understand your child’s health needs. State regulations require any child enrolled in the Arkansas Better Chance Pre-K program to have a well child check-up. In addition, the child must be current on ...
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[DOCX File]Physical Exam Form - Department of Health Home
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exchange of health information between the school nurse and health care providers. Signature of parent / guardian / emancipated student_____ Date_____ Page 2 of 4: PHYSICAL EXAM. STUDENT’S . HEALTH HISTORY (page 1 of this form) REVIEWED PRIOR TO . PERFOMING . EXAM . INATION: Yes No . Physical exam for grade: ...
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[DOC File]FLORIDA DEPARTMENT OF HEALTH IN MIAMI-DADE, …
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School records or medical information indicates your child has asthma. In order to attend to your child’s health and safety, the school requires a health history. Please return this form to the nurse as soon as possible. It will become part of your child’s confidential school health record. Our primary concern is that your child’s healthcare needs are met while in school.
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[DOT File]Authorization to Release Confidential Information
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AUTHORIZATION TO RELEASE CONFIDENTIAL INFORMATION Client Name Michigan Department of Health and Human Services Case Number Client ID Number Male Female Client’s Date of Birth County District Section Unit Worker TO: Worker Name Telephone Number/ext. SECTION 1: I authorize you to release the named adult and/or minor child’s information as described below.
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Department of health school forms