Search Results: MCHLine

Items in this list may be obtained from the sources cited. Contact information reflects the most current data about the source that has been provided to the MCH Digital Library.

Displaying records 1 through 12 (12 total).

District of Columbia Department of Health. 2022. Government of the District of Columbia school based oral health program consent form. Washington, DC: District of Columbia Department of Health, 2 pp.

Annotation: This consent form for parents to fill out allows students to receive care at school-based health centers in Washington, DC. It provides space to add contact information for the student and their parents and health professionals and information about health insurance. A description of services offered at school-based health centers is included. The form is available in Amharic, Chinese, English, French, Korean, Spanish, and Vietnamese.

Contact: District of Columbia Department of Health, 899 North Capitol Street, N.E., Washington, DC 20002, Telephone: (202) 442-5955 Fax: (202) 442-4795 E-mail: [email protected] Web Site: http://doh.dc.gov/ Available from the website.

Link

Keywords: Forms, Non English language materials, Parental consent, School age children, School health, Spanish language materials

Apple Tree Dental. [2017]. Consent for treatment of tooth decay (cavities) with silver diamine fluoride (SDF). [Rochester, MN]: Apple Tree Dental, 1 p.

Annotation: This form is designed for oral health professionals to give parents or guardians to obtain consent for treating a child’s tooth decay with silver diamine fluoride (SDF). The form provides information about what SDF is and how it works, limitations and side effects of SDF treatment, reasons to avoid SDF treatment, and other options for treating tooth decay. Photographs showing teeth before and after SDF treatment are included. The form includes space for the child’s name, tooth numbers to be treated, and the name and signature of the parent or guardian.

Contact: Apple Tree Dental, Web Site: https://www.appletreedental.org Available from the website.

Keywords: Fluoride, Oral health, Parental consent, Side effects, Treatment

Guttmacher Institute. 2012. Minors' access to prenatal care. New York, NY: Guttmacher Institute, 3 pp. (State policies in brief)

Annotation: This brief summarizes policies on minors' access to prenatal care in states across the country. It describes how these policies have changed over the past 30 years and highlights the differences in state laws regarding a minor's ability to access prenatal care. A chart indicates which states have explicit policies; whether or not parental consent is required for treatment; and whether or not physicians are allowed to inform parents when providing prenatal care to minors.

Contact: Guttmacher Institute, 125 Maiden Lane, New York, NY 10038, Telephone: (212) 248-1111 Secondary Telephone: (800) 355-0244 Fax: (212) 248-1951; Washington, D.C. Office (202) 223-5756 E-mail: [email protected] Web Site: http://www.guttmacher.org Available from the website.

Keywords: Access to health care, Adolescent health, Confidentiality, Parental consent, Policy, Prenatal care, State legislation

Oregon Health Authority, Oral Health Program. 2012. School-based fluoride rinse program: Parent permission form. Portland, OR: Oregon Health Authority, Oral Health Program, 1 p.

Annotation: This form is designed to assist schools in raising awareness about and participation in a school fluoride rinse program for students in grades 1–6 who have other sources of fluoride but who may be at risk for tooth decay owing to other factors. The form includes information about fluoride and has space for parents to indicate whether they want their child to take part in the fluoride rinse program. The form is available in English, Russian, Spanish, Vietnamese, and Somali.

Contact: Oregon Health Authority, Oral Health Program, 800 N.E. Oregon Street, Suite 850, Portland, OR 97232, Telephone: (971) 673-0348 Secondary Telephone: (971) 673-0372 Fax: (971) 673-0240 E-mail: [email protected] Web Site: https://public.health.oregon.gov/PreventionWellness/oralhealth/Pages/index.aspx Available from the website.

Keywords: Disease prevention, Fluorides, Non English language materials, Parental consent, Preventive health services, School age children

Colorado Association for School-Based Health Care. 2011. Understanding minor consent and confidentiality in Colorado: An adolescent provider toolkit. [Denver, CO]: Colorado Association for School-Based Health Care, 9 pp.

Annotation: This adolescent reproductive health toolkit includes Colorado-specific statutes and information related to minor consent and confidentiality. Adapted from a toolkit developed by the Adolescent Health Working Group and the Adolescent Health Collaborative, the tooklit includes legal information, charts on minor consent and confidentiality, practice tools, resource sheets, online resources and research, information addressing issue of Health Insurance Portability and Accountability Act (HIPAA) and Family Educational Rights and Privacy Act (FERPA), and health education handouts for adolescents and their parents or guardians. The information applies to teens who use school-based health centers, and to teens accessing services in a variety of medical settings.

Contact: Colorado Association for School-Based Health Care, 1801 Wiliams Street, Suite 400, Denver, CO 80218, Telephone: (303) 399-6380 Fax: (303) 350-4296 E-mail: [email protected] Web Site: http://www.casbhc.org Available from the website.

Keywords: Adolescent health, Colorado, Confidentiality, Consent, Parental consent, Patient consent, Reproductive health, State legislation

Oregon Health Authority, Oral Health Program. 2011. School-based fluoride tablet program: Parent permission form. Portland, OR: Oregon Health Authority, Oral Health Program, 1 p.

Annotation: This form is designed to assist schools in raising awareness about and participation in a school fluoride tablet program for students in grades K–6 who live in areas without optimum levels of fluoride in the water supply and who are not taking fluoride tablets at home. The form includes information about fluoride and has space for parents to indicate whether they want their child to take part in the fluoride tablet program. The form is available in English, Russian, Spanish, Vietnamese, and Somali.

Contact: Oregon Health Authority, Oral Health Program, 800 N.E. Oregon Street, Suite 850, Portland, OR 97232, Telephone: (971) 673-0348 Secondary Telephone: (971) 673-0372 Fax: (971) 673-0240 E-mail: [email protected] Web Site: https://public.health.oregon.gov/PreventionWellness/oralhealth/Pages/index.aspx Available from the website.

Keywords: Disease prevention, Fluorides, Forms, Non English language materials, Oregon, Parental consent, Parents, Preventive health services, School age children, School health programs, Schools, State programs

Guttmacher Institute. 2010. An overview of abortion laws. New York, NY: Guttmacher Institute, 3 pp. (State policies in brief)

Annotation: This document highlights major provisions of state laws related to abortion that have been constructed by states since the Supreme Court handed down its 1973 decisions Roe v. Wade and Doe v. Bolton. The state laws codify and regulate, and limit whether and under what circumstances a woman may obtain an abortion. Topics include: partial-birth abortions, public funding, coverage by private insurer, refusal to participate, state-mandated counseling, waiting periods, and parental involvement. The chart links to additional resources on several of these topics.

Contact: Guttmacher Institute, 125 Maiden Lane, New York, NY 10038, Telephone: (212) 248-1111 Secondary Telephone: (800) 355-0244 Fax: (212) 248-1951; Washington, D.C. Office (202) 223-5756 E-mail: [email protected] Web Site: http://www.guttmacher.org Available from the website.

Keywords: Abortion, Financing, Insurance, Legislation, Parental consent, State legislation

Guttmacher Institute. 2010. An overview of minors' consent laws. New York, NY: Guttmacher Institute, 2 pp. (State policies in brief)

Annotation: This document consists primary of a table that contains seven categories of state law that affect minors' right to receive medical care without parental consent. Highlights of the table are also presented in the following areas: contraceptive services, sexually transmitted infection services, prenatal care, adoption, medical care for a child, and abortion.

Contact: Guttmacher Institute, 125 Maiden Lane, New York, NY 10038, Telephone: (212) 248-1111 Secondary Telephone: (800) 355-0244 Fax: (212) 248-1951; Washington, D.C. Office (202) 223-5756 E-mail: [email protected] Web Site: http://www.guttmacher.org Available from the website.

Keywords: Abortion, Access to health care, Adolescent health, Adolescent parents, Adoption, Child health, Contraceptive use, Health services, Informed consent, Parental consent, Prenatal care, Sexually transmitted diseases, State legislation

North Dakota Health Department, Oral Health Program. 2007–. Fluoride varnish. Bismarck, ND: North Dakota Health Department, Oral Health Program,

Annotation: This section of the North Dakota Oral Health Program Web site contains resources on fluoride varnish. Resources for health professionals include a fluoride varnish reference guide, risk-assessment tool, Medicaid reimbursement guidelines, the North Dakota legal authorities to apply fluoride varnish, a sample consent form and standing medical order, and a list of supplies. A research brief on the evidence base for fluoride varnish and a brochure and fact sheet for parents and other caregivers of young children are also included. [Funded by the Maternal and Child Health Bureau]

Contact: North Dakota Department of Health and Human Services, Oral Health Program, 600 East Boulevard Avenue, Department 310, Bismarck, ND 58505-0250, Telephone: (800) 472-2286 Secondary Telephone: (701) 328-2356 Fax: (701) 328-1412 Web Site: https://www.hhs.nd.gov/health/oral-health-program Available from the website.

Link

Keywords: Children, Fluorides, Forms, Guidelines, Medicaid, Oral health, Parental consent, Parents, Reference materials, Reimbursement, Resources for professionals, State legislation, State programs

Michigan Department of Community Health Oral Health Program. 2005. Count Your Smiles screening protocol: Guidelines for screeners. Lansing, MI: Michigan Department of Community Health Oral Health Program, 37 pp.

Annotation: This document describes the protocol for collecting baseline data on the oral health status of children in Michigan. The goal is to build capacity and skills for collecting community-specific oral health data. Topics include sample selection, informed consent, oral health education in the classroom, infection control, lighting, retraction and visualization, removing food debris from teeth, and instrumentation. Data elements include cavitated lesions, caries experience, dental sealants, and treatment urgency. Codes, screening figures, a dentition chart, and information about coordination activities and screener responsibilities, data management, supplies, and contacts are also provided. The appendices contain sample letters; forms; instructions; and billing, reporting, and evaluation sheets.

Contact: Michigan Department of Health and Human Services, Capitol View Building, 201 Townsend Street, Lansing, MI 48913, Telephone: (517) 373-3740 Web Site: http://www.michigan.gov/mdhhs Available from the website.

Keywords: Children, Data collection, Dental caries, Forms, Health status, Michigan, Oral health, Parental consent, Protocols, Screening, State surveys

National Center for Youth Law. 1995. State minor consent statutes: A summary. Cincinnati, OH: Children's Hospital Medical Center, Center for Continuing Education in Adolescent Health, 197 pp.

Annotation: This report is a collection of state legislation relating to minors' access to and use of health care. The introduction, containing information about the legal framework that affects the health care provider's delivery of services to minors, considers questions pertaining to consent, confidentiality, and financial responsibility. The report includes the statutes of all 50 states and the District of Columbia. Individual entries list the state provisions first, referencing the pertinent statutes, then provide a brief synopsis of the relevant sections of specific provisions concerning minors, their status, and types of health care. [Funded in part by the Maternal and Child Health Bureau]

Contact: Children's Hospital Medical Center, Center for Continuing Education in Adolescent Health, Division of Adolescent Medicine, 3333 Burnet Avenue, Cincinnati, OH 45229-3039, Telephone: (513) 559-4877 Available in libraries. Document Number: HRSA Info. Ctr. MCHH138.

Keywords: Access to health care, Adolescents, Confidentiality, Consent, Costs, Health professionals, Individual responsibility, Legal responsibility, Parental consent, Right to treatment, State legislation

Ooms T, Owen T. 1990. Parents' role in teenage health problems: Allies or adversaries?. Washington, DC: American Association for Marriage and Family Therapy, Research and Education Foundation, Family Impact Seminar, 35 pp. (Family impact seminars)

Annotation: This report summarizes a seminar focusing on the parents' role in helping adolescents with their health concerns. Presentation topics included an overview of the law with respect to adolescent health, parental consent, and notification; the relationship of the family and the health care system; a parent's personal experience with Toughlove, an international self-help organization for parents of adolescents who have behavioral problems or abuse alcohol and other drugs; and a parent's personal and professional experience with the Federation of Families for Children's Mental Health. The seminar is one of a series called Family Impact Seminars which are funded by the Maternal and Child Health Bureau and cosponsored by the Coalition of Family Organizations. [Funded by the Maternal and Child Health Bureau]

Keywords: Adolescent health, Families, Health care systems, Legislation, Parent professional relations, Parental consent