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Evaluation/Referral Worksheet

This simple checklist will help with assessing oral health status, risk factors, and making referrals for clients, when needed.

Follow this link to download the evaluation/referral worksheet (editable document requires Microsoft Word and will open in the downloads feature of your browser).


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Microsoft Word Viewer icon Some of the files available on this page are in Microsoft Word format which requires Microsoft Word or Word Viewer. A free copy of Microsoft Word Viewer   can be downloaded directly from Microsoft,