K-12 Mobile Dental is committed to providing accessible and convenient dental hygiene services to children within the school environment.

This webpage provides access to the required consent form for participation in our school-based dental program.

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By clicking the "Click Here" button below, you will be redirected to a secure online form where you can review and complete the necessary authorization for your child to receive dental hygiene services from K-12 Mobile Dental. This form will outline the specific procedures offered, potential risks and benefits, and provide you with the opportunity to grant or decline consent. Please carefully review all information before submitting the form.

Providing your consent electronically through this secure portal ensures efficient processing and allows us to prepare appropriately for your child's dental appointment. Your privacy is of utmost importance to us.

All information provided will be treated confidentially and in accordance with applicable privacy regulations, including the Health Insurance Portability and Accountability Act (HIPAA)

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