For School Staff and Nurses

For Nurses

The referral process is easy & quick and we can assist parents with accessing a local pediatric dentist, free of charge, for treatment of decay. When a school nurse or health aid identifies a child who has visible decay, the Nurse simply makes a referral to KCCDHN office. The process is simple. Just complete the brief referral form, fax or email to baantongiovanni@kern.org and our staff will facilitate an appointment with one of our 2 subcontracted pediatric dentists.

All necessary medical forms and assistance for parents will be completed by phone by our program staff. At the first dental appointment, medical forms will be reviewed and signed by the parent. Translation services, if needed, are also provided.

• The Nurse Referral System is available to children ages 0-5 who have visible decay or are experiencing pain.
• Referrals can be submitted throughout the year.
• Referral forms are brief and easy to complete.
• Staff is bilingual and available to provide information to nurses/health aids and parents.
• Just complete the brief referral form, fax or email to baantongiovanni@kern.org and our staff will facilitate an appointment with one of our 2 subcontracted pediatric dentists. All necessary medical forms and assistance for parents will be completed by phone by our program staff. At the first dental appointment, medical forms will be reviewed and signed by the parent. Translation services, if needed, are also provided.

Resources

• Nurse Referral Form
• KCCDHN Nurse Referral Program Brochure
• PM160 Dental Classification Guide
• The American Dental Association’s “Classification of Treatment Needs” is a tool to use when referring children for dental services.