Don’t forget to enroll your child for our FREE school-based dental program, including Dental Exams, X-rays, Dental cleanings, Dental sealants, Fluoride and Fillings! We accept enrollment forms all year, but to ensure they receive services at the upcoming clinic, please submit consents as soon as possible. Forms are available in the school office or through the online secure forms at the following link: https://heartlandhealth.org/healthy-futures/ . You may also print the attached form and return to the school nurse or directly to the Healthy Futures Coordinator, Amanda, at the following email: healthyfutures@heartlandhealth.org. Healthy Futures accepts Medicaid, Commercial Insurance, and the uninsured. There is NO COST to you even if your child is uninsured or not fully covered through commercial insurance. This program is open to all students, no restrictions. If you have any questions, please feel free to contact Amanda at 785-841-7297, ext. 351

Please find the attached pdf below of our information sheet along with the consent forms in both English and Spanish including QR Codes to easily access our online consent form via a smart phone. Here is the link to our Healthy Futures website. Our website provides parents with an overview of our program, as well as the downloadable forms and the links to the online forms. https://heartlandhealth.org/healthy-futures/

PDF Consent Form