2g_notice of screening results

2g_notice of screening results.docx

Oral Health Basic Screening Survey for Children

2g_notice of screening results

OMB: 0920-1346

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Notice of oral health screening results

Sample Screening Results Letter for Parents


{state} DEPARTMENT OF HEALTH



Child’s Name:



Date:



Dear Parent or Caretaker,


As part of the Make Your Smile Count Survey, your child received a dental screening at school. No x-rays were taken, and the screening does not replace an in-office dental examination by a dentist. The results of the screening indicate that:


Your child has no obvious dental problems but should continue to have routine dental examinations by a dentist.


Your child has a tooth or teeth that should be evaluated by a dentist. The dentist will determine whether treatment is needed.


Your child has a tooth or teeth that appear to need immediate care. Contact a dentist as soon as possible for a complete evaluation and appropriate treatment.


If you do not have a family dentist and you need assistance obtaining dental care or insurance, you may contact {name of referral source for area}.





Sincerely,





Name, title, affiliation





File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorLin, Mei (CDC/DDNID/NCCDPHP/DOH)
File Modified0000-00-00
File Created2021-02-04

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