Get the free choc breathmobile school referral form - ocde

CHOC Breath mobile SCHOOL Referral Form. 455 S Main Street. Orange, CA 92868. (714) 532-7571 Appointment Line. (714) 532-7550 Fax Line. Please fax ...

How to fill out choc breathmobile school referral

How to fill out choc breathmobile school referral:

1. Gather necessary information: Start by collecting the required details for the referral such as the student's name, age, grade level, contact information, and any medical history or dental concerns.
2. Contact the breathmobile program: Reach out to the choc breathmobile program either through their website or by phone to inquire about the specific referral process. They will provide you with the necessary forms and instructions.
3. Complete the referral form: Fill out the provided referral form accurately and completely. Make sure to provide all the requested information, including any relevant medical or dental history that may help the professionals at choc breathmobile better understand the student's needs.
4. Obtain required signatures: If the referral form requires any signatures, ensure that they are obtained from the appropriate individuals, such as the parent or legal guardian.
5. Submit the referral: Once all the required information is filled out and signatures obtained, submit the referral form to the choc breathmobile program. Pay attention to any specific submission instructions provided by the program, such as mailing, faxing, or dropping off the form in person.

Who needs choc breathmobile school referral:

1. Children with limited access to dental care: The choc breathmobile school referral is intended for children who may have limited access to dental care. This could include students from underserved communities, low-income families, or those without dental insurance.
2. Students with oral health concerns: The choc breathmobile program aims to provide dental services to students who have oral health concerns. These concerns could include tooth decay, gum disease, need for preventive services like cleanings or sealants, or any other dental issues that require professional attention.
3. Parents or guardians seeking dental services for their child: The choc breathmobile school referral is beneficial for parents or guardians who want to ensure their child receives necessary dental care but may face barriers to accessing a traditional dental office. The referral provides an opportunity for these parents or guardians to connect their child with the choc breathmobile program for dental services.

For pdfFiller’s FAQs

What is choc breathmobile school referral?

Choc Breathmobile School Referral is a form used to refer students to the CHOC Children's Breathmobile program for asthma management and education.

Who is required to file choc breathmobile school referral?

School nurses or healthcare providers are required to file Choc Breathmobile School Referral for students who may benefit from the program.

How to fill out choc breathmobile school referral?

Choc Breathmobile School Referral can be filled out online or by completing a paper form with student's information and medical history.

What is the purpose of choc breathmobile school referral?

The purpose of Choc Breathmobile School Referral is to provide students with access to asthma management services and education through the CHOC Children's Breathmobile program.

What information must be reported on choc breathmobile school referral?

Choc Breathmobile School Referral must include student's demographics, medical history, asthma symptoms, and any current treatment plans.

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