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  • Smart Smiles logo. Smiling tooth holding a pencil.

    PrimeHealth+ Parent Consent

    School Year 2025-2026
  • All fields marked with * are required and must be filled.

     

    PrimeHealth+ ("PH+"; formerly MarillacHealth) is providing free dental screenings to students. PH+ dental hygienists will provide screening and fluoride varnish application at your child's school. These services are preventative and educational. This form releases any liability of PH+ during this activity. PrimeHealth+ may call you regarding further urgent dental needs of your student.

    Cavities (also known as caries or tooth decay) are the most common chronic disease of childhood in the United States. Untreated cavities can cause pain and infections that may lead to problems with eating, speaking, playing, and learning. Children who have poor health often miss more school and receive lower grades than children who don't. CDC Oral Health Basics for Children

    Even if your child already has a dental home, we recommend your participation to reinforce healthy habits. If you have more than one student attending the school, please complete a form for each of them.

    There will be no out-of-pocket cost for the services provided at the school screening. Certain insurances will cover the cost of the screening and fluoride application.

    FLUORIDE VARNISH

    Fluoride is a naturally occurring mineral that bonds with the crystal structure of a tooth and provides increased protection from tooth decay. Fluoride is highly recommended by the American Dental Association as well as the American Academy of Pediatrics. Fluoride is safe in regulated doses for children and adults.

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