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DHHS Head Start Oral Health Form - Children 2023-2025 free printable template

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This form is designed to collect information about a child's oral health status, the services delivered during dental visits, and details for future care.
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How to fill out DHHS Head Start Oral Health Form

01
Obtain the DHHS Head Start Oral Health Form from the appropriate source.
02
Fill out the child's personal information, including name, date of birth, and parent/guardian details.
03
Complete the section on dental health history, including information about past dental visits and any known dental issues.
04
Specify any allergies or medical conditions that may affect oral health.
05
Provide the name and contact information of the child's dentist.
06
Sign and date the form to affirm that the information provided is accurate.
07
Submit the completed form to the designated Head Start program contact.

Who needs DHHS Head Start Oral Health Form?

01
Children enrolled in the DHHS Head Start program.
02
Parents or guardians of children in the Head Start program who need to submit the child's oral health information.
03
Dental care providers who are collaborating with Head Start programs.
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Oral health assessment tool (OHAT) It consists of a visual inspection using eight categories of oral health: lips. tongue. gums and oral tissue. saliva.
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An oral health assessment, also known as a dental examination, is a thorough evaluation of your oral health. This typically includes an examination of the teeth, gums, tongue, and other parts of the mouth, as well as a review of your medical and dental history.
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The DHHS Head Start Oral Health Form is a document used to assess and report the oral health status of children enrolled in the Head Start program, ensuring they receive necessary dental care.
The form is typically required to be filed by dental health professionals who conduct oral health evaluations for children in the Head Start program, as well as the parents or guardians of the enrolled children.
To fill out the form, dental health professionals should complete sections detailing the child's dental examination results, treatment needs, and any referrals made. Parents or guardians may need to provide personal information about the child.
The purpose of the DHHS Head Start Oral Health Form is to ensure that children in the Head Start program receive appropriate oral health evaluations and follow-up treatments, promoting overall health and well-being.
The form must report information such as the child's name, birth date, dental examination findings, diagnosis, treatment recommendations, and any referrals to dental specialists.
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