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Download Rose Tree Media School District Dear Parents: The Pennsylvania
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Rose Tree Media School District 308 North Olive Street Media, Pennsylvania 19063-2493 Telephone 610.627.6000 Fax 610.565.5317 www.rtmsd.org James M. Wigo, Sr. Superintendent of Schools Eleanor DiMarino-Linnen, Ph.D. Director of Pupil Services and Special Education Dear Parents: The Pennsylvania School Health Regulations require that children entering school for the first time in either kindergarten or first grade, and all students in third grade, and seventh grade receive a dental examination. This is NOT an orthodontic examination. The State is suggesting that the parents or guardians of the children in these grades have the examination done by their family dentist. The report your dentist is to use for the examination is presented below. The District will accept proof of private dental examination that was completed within one calendar year prior to the students entry into the grade in which the examination is required. (Board Policy No. 209) In order to have your child’s records complete, we must have this form returned to your child’s school nurse by Friday of the first full week of school. If this form is not returned, the school dentist or hygienist will perform the required dental examination of your child. Thank you. School Nurse Phone Number Fax Number Indian Lane Amy Lenton 610-627-7104 610-566-6582 Glenwood Debra Taylor 610-627-6903 610-892-7193 Media Catherine Boylan 610-627-6805 610-566-3745 Rose Tree Kathryn Johnson 610-627-7228 610-566-5087 Springton Lake Leslie Goldsmith 610-627-6512 610-566-8665 ____________________________________________________________________________________ FAMILY DENTIST REPORT Name of Child _______________________________________________________________________ Birth Date ___________________________________________________________________________ Grade _________________________________ Teacher _______________________________ School _____________________________________________________________________________ The above-named child visited my office ___________________________________________________ Date At that time all necessary corrections were made. Yes _______ No _______ _____________________________________ Signature of Dentist
