Florida Oral Health

Sealant Program Consent Forms by County

Alachua County:

• Alachua Dental Sealant Permission Slip
• Alachua Parent Permission _Spanish
• Alachua School Participation Request letter

Lake County:

• Parent Instruction Letter- English 2012-2013
• Parent Instruction Letter- Spanish 2012-2013
• Parent Permission Form- English 2012-2013
• Parent Permission Form-Spanish 2012-2013
• Treatment Letter to Parent-English 2012-2013
• Treatment Letter to Parent- Spanish 2012-2013

Hillsborough County:

• Parent Permission Slip- English 2012

Orange County:

• Initiation of Services Letter- English 2012
• Paren Permission Form-English 2012
• Results Handout Form-English 2012

Palm Beach County:

• School Dental Sealant Program Results - Creole
• School Dental Sealant Program Results - English
• Dental Sealant Permission - Creole
• Dental Sealant Permission - English
• Dental Sealant Permission - Spanish
  Dental Sealant Program Clinical Record

Pasco County:

• Dental Sealant Permission - English
• Dental Health History - English
• Parent Initial Contact - English

Volusia County:

• Parent Initial Contact-English
• Treatment Completed- English
• Parent Medical History- English
• Parent Second Chance Form-English
• Parent Initial Contact- Spanish
• Parent Second Chance Form-Spanish