School Dental Hygiene Program Permission Form 2019-2020 School Year


P.O. Box 314 Lewiston, Maine 04243 | Office (207) 513-1111| ToothProtectors.org
PLEASE FILL OUT IF YOU WANT YOUR CHILD SEEN
 THIS FORM PROVIDES PERMISSION FOR YOUR CHILD TO BE SEEN TWO TIMES DURING THIS SCHOOL YEAR FOR DENTAL CARE

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