What forms do the children in each school receive?

All children receive a consent form that must be completed and signed by a parent or guardian indicating that they give permission (“YES”) for their child to participate in the Miles of Smiles-Laredo program. Children who do not bring back forms or children who bring back forms with the box marked "NO" do not receive a screening or any dental services from the Miles of Smiles-Laredo program. The Miles of Smiles-Laredo program asks parents to return all consent forms. By returning the “NO” consent form, the Miles of Smiles-Laredo program is assured that you had the opportunity to consider participating in this free program.

  1. Consent Form Cover Sheet - English
  2. Consent Form Cover Sheet - Español
  3. Consent Form - English
  4. Consent Form - Español
  5. Referral Sheet to Find a Dentist in Your Area - Both English and Spanish
  6. Student Report Form - Both English and Spanish

Student Report Form:

After the child receives a limited oral evaluation, a Student Report Form is sent home describing the results. If the Student Report Form indicated the need to see a dentist as soon as possible, it means that the Miles of Smiles-Laredo dentist observed a cavity or other dental problem. Parents of children who have urgent dental needs will be contacted by a member of the Miles of Smiles staff. If the child does not have a regular dentist, the case managers will help the parent to identify a local dentist. Case managers are able to assist school nurses to identify providers in the community for children or families who do not currently have a dentist.