Form Examination – Fill Out and Use This PDF

Form Examination PDF Details

The Examination Form from the State of Illinois, under the Illinois Department of Public Health, serves as a vital document verifying the dental health status of school-aged children for educational institutions. This Proof of School Dental Examination Form outlines several key sections that require completion by both the parent or guardian and the dentist. The parent section solicits basic information about the student, including name, birth date, address, telephone number, school name, grade level, and gender, ensuring that the student's educational and health records are accurately matched and maintained. Meanwhile, the dentist's portion delves into the oral health status of the student, with checkboxes provided for various conditions such as the presence of dental sealants, caries experience or restoration history, untreated caries, soft tissue pathology, and malocclusion. Beyond merely noting existing conditions, the form requires the dentist to identify specific treatment needs, categorizing them into urgent treatment, restorative care, preventive care, and other needs, highlighting the importance of a comprehensive approach to oral health in children. Additionally, the form facilitates communication between dental professionals and the school by allowing dentists to note pertinent details regarding the examination and by providing contact information for further inquiries. This document, sanctioned by the Illinois Department of Public Health and embodying both a commitment to the dental wellbeing of school-aged children and a procedural tool for health management in educational settings, underscores the intertwined nature of health and education policies.