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  • PERMISSION SLIP Dental

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    rhenhipolito.rh
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    This permission slip grants a parent or guardian's approval for their child to be treated at the school clinic, specifically to receive fluoride application. The parent must print their child's name, sign their own name, and provide the school and class details for the purpose of dental treatment at school.

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    PERMISSION-SLIP-dental

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    This permission slip grants a parent or guardian's approval for their child to be treated at the school clinic, specifically to receive fluoride application. The parent must print their child's name, sign their own name, and provide the school and class details for the purpose of dental treatment at school.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as docx, pdf, or txt
    18 views1 page

    PERMISSION SLIP Dental

    Uploaded by

    rhenhipolito.rh
    This permission slip grants a parent or guardian's approval for their child to be treated at the school clinic, specifically to receive fluoride application. The parent must print their child's name, sign their own name, and provide the school and class details for the purpose of dental treatment at school.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as docx, pdf, or txt
    of 1

    PERMISSION SLIP PERMISSION SLIP PERMISSION SLIP PERMISSION SLIP PERMISSION SLIP

    I hereby grant permission to have my child I hereby grant permission to have my child I hereby grant permission to have my child I hereby grant permission to have my child I hereby grant permission to have my child
    ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________

    be treated in the school clinic. (Flouride Application) be treated in the school clinic. (Flouride Application) be treated in the school clinic. (Flouride Application) be treated in the school clinic. (Flouride Application) be treated in the school clinic. (Flouride Application)

    ________________________________ ________________________________ ________________________________ ________________________________ ________________________________

    Name & Signature of Parent/Guardian Name & Signature of Parent/Guardian Name & Signature of Parent/Guardian Name & Signature of Parent/Guardian Name & Signature of Parent/Guardian

    School : _______________________________ School : _______________________________ School : _______________________________ School : _______________________________ School : _______________________________

    Grade / Section :________________________ Grade / Section :________________________ Grade / Section :________________________ Grade / Section :________________________ Grade / Section :________________________

    PERMISSION SLIP PERMISSION SLIP PERMISSION SLIP PERMISSION SLIP PERMISSION SLIP

    I hereby grant permission to have my child I hereby grant permission to have my child I hereby grant permission to have my child I hereby grant permission to have my child I hereby grant permission to have my child
    ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________

    be treated in the school clinic. (Flouride Application) be treated in the school clinic. (Flouride Application) be treated in the school clinic. (Flouride Application) be treated in the school clinic. (Flouride Application) be treated in the school clinic. (Flouride Application)

    ________________________________ ________________________________ ________________________________ ________________________________ ________________________________

    Name & Signature of Parent/Guardian Name & Signature of Parent/Guardian Name & Signature of Parent/Guardian Name & Signature of Parent/Guardian Name & Signature of Parent/Guardian

    School : _______________________________ School : _______________________________ School : _______________________________ School : _______________________________ School : _______________________________

    Grade / Section :________________________ Grade / Section :________________________ Grade / Section :________________________ Grade / Section :________________________ Grade / Section :________________________

    PERMISSION SLIP PERMISSION SLIP PERMISSION SLIP PERMISSION SLIP PERMISSION SLIP
    I hereby grant permission to have my child I hereby grant permission to have my child I hereby grant permission to have my child I hereby grant permission to have my child I hereby grant permission to have my child
    ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________
    be treated in the school clinic. (Flouride Application) be treated in the school clinic. (Flouride Application) be treated in the school clinic. (Flouride Application) be treated in the school clinic. (Flouride Application) be treated in the school clinic. (Flouride Application)

    ________________________________ ________________________________ ________________________________ ________________________________ ________________________________


    Name & Signature of Parent/Guardian Name & Signature of Parent/Guardian Name & Signature of Parent/Guardian Name & Signature of Parent/Guardian Name & Signature of Parent/Guardian
    School : _______________________________ School : _______________________________ School : _______________________________ School : _______________________________ School : _______________________________
    Grade / Section :________________________ Grade / Section :________________________ Grade / Section :________________________ Grade / Section :________________________ Grade / Section :________________________

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