Parental Permission Forms

Sealants for Smiles provides dental sealants at no cost to eligible 2nd and 6th grade children within the elementary school they attend.  All children must obtain a signed permission form from their parent/guardian in order for the child to be seen by the Sealants for Smiles clinic. You may download our forms in English and Spanish below. 

 

English

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Spanish

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Arabic

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Bosnian

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French

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Russian

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Somali

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Tongan

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Vietnamese

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