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    Dj22 Jake
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    The document contains a parent's permit form from Alangilan National High School allowing a student to receive a fluoride varnish application during a dental visit at the school on October 20, 2023. The form requires signatures from the student's adviser and parent to provide consent for the dental procedure.

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    The document contains a parent's permit form from Alangilan National High School allowing a student to receive a fluoride varnish application during a dental visit at the school on October 20, 2023. The form requires signatures from the student's adviser and parent to provide consent for the dental procedure.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    6 views1 page

    Department of Education

    Uploaded by

    Dj22 Jake
    The document contains a parent's permit form from Alangilan National High School allowing a student to receive a fluoride varnish application during a dental visit at the school on October 20, 2023. The form requires signatures from the student's adviser and parent to provide consent for the dental procedure.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    Department of Education

    Region VI – Western Visayas


    Division of Bacolod City
    ALANGILAN NATIONAL HIGH SCHOOL
    Bacolod City

    PARENT’S PERMIT
    This is to certify that I’m allowing my son/daughter __________________ to
    receive Fluoride Varnish application at Alangilan National High School during Dental
    Visit tomorrow, October 20, 2023.

    _______________________________ _____________________________________
    Adviser Signature over printed name of parent (s)

    Region VI – Western Visayas


    Division of Bacolod City
    ALANGILAN NATIONAL HIGH SCHOOL
    Bacolod City

    PARENT’S PERMIT
    This is to certify that I’m allowing my son/daughter __________________ to
    receive Fluoride Varnish application at Alangilan National High School during Dental
    Visit tomorrow, October 20, 2023.

    _______________________________ _____________________________________
    Adviser Signature over printed name of parent (s)

    PARENT’S PERMIT
    This is to certify that I’m allowing my son/daughter __________________ to
    receive Fluoride Varnish application at Alangilan National High School during Dental
    Visit tomorrow, October 20, 2023.

    _______________________________ _____________________________________
    Adviser Signature over printed name of parent (s)

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