Oral Health Forms

The Office of Head Start oral health forms are important records of a pregnant woman’s or child’s dental visit. The forms provide information on dental home and current oral health status, and what oral health care services were delivered during the dental visit. These services include diagnostic and preventive services, counseling, restorative and emergency care, and referral to a specialist for care. The forms also record what oral health care services are needed and any information to share with others.

Head Start Oral Health Form—Children

Head Start Oral Health Form—Pregnant Women

Head Start Oral Health Form—Children and Pregnant Women

Sample provider letter

Frequently Asked Questions

Topic:Oral Health

Keywords:Dental carePregnant women and expectant families

Resource Type: Article

National Centers: Early Childhood Health and Wellness

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