For Parents
Consent form/Medical History
– You may have received this at the beginning of the school year, but if your child is new or has lost their form print, complete, and return to school if you want your child to participate in the sealant program. Here is a list of participating schools
Consent form/Medical History En Espanol
HIPPA Statement
– Copy of privacy information
Report of Dental Inspection
– You will receive a report that looks like this with the dentist’s findings from your child’s screening or exam.
Report of Dental Inspection En Espanol
Silver Diamine Fluoride Reports
–SDF Treatment Report in English and Spanish
Sealant Fact Sheet
– Useful information on sealants
For Faculty and Staff
Information packets
- Introduction letter to elementary school faculty and staff
- Introduction letter to middle school faculty and staff
- Endorsement letter from Knox County Schools
- Materials Needed Sheet
– Explains what schools need to provide to KCHD to help implement the program.
For more information, contact the Knox County School-Based Dental Prevention Program, at kchd.sbdpp@knoxcounty.org, or by phone at 865-215-5773.