OCRS 2021 2022 Annual School Dental Screening Parent Form

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Dear OCRS families:

Rhode Island State Law section 16-21-9(b) mandates that all students in elementary schools be examined by a dentist at least ONCE a year and once during Grades K-5. Students who are seen yearly by their own dentist DO NOT need to be screened at school.

Please complete the form linked below for your students who are currently enrolled at OCRS. Any student who does not have a response listed in the completed form below shall participate in the annual school dental screening.

Email *

Child/Children's' Last and First Name *

Please list the last name and first name of each of your children that currently attend OCRS

Child/Children's Grade (s) *

Please select all of the grade levels in which your children are currently enrolled at OCRS

Kindergarten

1st grade

2nd grade

3rd grade

4th grade

5th grade

Required

Participating in the annual school dental screening? *

Yes, My child WILL PARTICIPATE IN THE SCHOOL DENTAL SCREENING because he/she does not have a current dentist.

No, My child will not need to participate in the school screening and he/she visits his/her dentist annually for dental checkups.

Send me a copy of my responses.

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