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Appendix A SCHOOL FLUORIDE MOUTHPIECE PROGRAM ORDER/REPORT FORM DATE: 1. School Information: Name of School: Name of School District: Mailing Address: City County State Zip: Name of Primary Contact:
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How to fill out school fluoride mouthrinse program

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How to fill out a school fluoride mouthrinse program:

01
Begin by reviewing the program guidelines provided by your school or district. These guidelines will outline the specific steps and requirements for participation in the fluoride mouthrinse program.
02
Take note of any deadlines or registration forms that need to be completed. Fill out the necessary paperwork accurately and completely, providing any required personal or contact information.
03
Ask your child's dentist or dental hygienist for their recommendation regarding participation in the fluoride mouthrinse program. They may provide additional guidance or information about the program's benefits for your child's oral health.
04
Familiarize yourself with the consent form provided by the school. Read through the form carefully, ensuring that you understand the risks and benefits of the program. If you have any questions or concerns, don't hesitate to reach out to the school or your child's dentist for clarification.
05
If you decide to participate in the program, sign and submit the consent form according to the provided instructions. Make sure to keep a copy of the form for your records.
06
Follow any additional instructions provided by the school, such as attending an orientation session or picking up the fluoride mouthrinse solution on a specific date.
07
Remind your child about the importance of following the program's instructions when using the fluoride mouthrinse, such as the proper amount to use and the recommended frequency of use.
08
Monitor your child's participation in the program and regularly communicate with the school or your child's dentist about any concerns or questions that may arise.

Who needs a school fluoride mouthrinse program:

01
The school fluoride mouthrinse program is beneficial for children who may have a higher risk of developing dental decay or cavities.
02
Children who have difficulty maintaining proper oral hygiene habits or who have a history of dental problems may particularly benefit from the fluoride mouthrinse program.
03
The program can also be helpful for families who may not have access to regular dental care or preventive treatments, as it provides an additional layer of protection for their children's oral health.
Overall, the school fluoride mouthrinse program can be a valuable tool in promoting and maintaining good oral health for participating children.
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The school fluoride mouthrinse program is a program implemented in schools where students are provided with fluoride mouthrinse to help prevent tooth decay.
The school administration or designated staff members are required to file the school fluoride mouthrinse program.
To fill out the school fluoride mouthrinse program, the designated staff members need to provide information about the program implementation and outcomes.
The purpose of the school fluoride mouthrinse program is to improve oral health and reduce tooth decay among school children.
The information reported on the school fluoride mouthrinse program includes the number of students participating, frequency of mouthrinse use, and any observed outcomes.
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