Secure online form

Oral health consent.

Please complete this form to provide consent for your child's dental care through our school oral health program.

Estimated Time

3–5 Minutes

Who Should Complete?

Parent / Guardian

Need Ready

Medicare Card (Optional)

Child Information

Parent Information

Medical Information

Medicare Information

Consent

Review & Submit

Step 1 of 617%

Child Information

Child's Information

Please provide your child's basic details before continuing.

Getting to know your child

Child’s information

Enter their details as they appear on official records.

Full name

Your child’s legal name.

Title*

First Name*

Middle Name

Last Name*

Personal details

Helps us prepare for their care.

Date of Birth*

Gender*

Before you continue

Please ensure the child's name and date of birth match their Medicare card or other official documents. Incorrect information may delay processing of your consent form.

Step 1 of 6