COMMONWEALTH MOBILE ORAL HEALTH SERVICES,LLC

“A Child’s Smile is What We Should All Be About”

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Letters from Patients
Where We Refer To
TIPS FOR ORAL HYGIENE
A Sampling of CMOHS Documents
(All Forms can be translated into most languages)
 Consent for Treatment
  • To view or download a copy of the CMOHS consent form, please click here.  
  • To view or download a copy of the CMOHS/Tufts University consent form, please click here.
  • To view or download a copy of the CMOHS consent form used in the Boston Public Schools as part of the SMART SMILES collaboration with Tufts University, Harvard University, Forsyth School of Dental Hygiene, and Boston University, please click here.
  • To view or download a copy of the BEST Oral Health consent form we use in the Springfield area, please click here.
Privacy policy
Dental documents
  • If you need Dental records released to another office, Please download our Record Release authorization form, have a parent or legal guardian sign the form and fill it out and mail the completed form to CMOHS 12 Colleen Drive Lakeville, MA 02347.
  • Does a patient need an extraction?  Even baby teeth require an extraction consent form to be filled out.
  • Do you think a patient needs a referral?  Take a look at our handy referral sheet, filled out in triplicate by the dentist.  Your program will also be provided with an extensive list of referral sites in the area applicable to your referral needs.  View the Referral in Spanish here.
  • Do you have a child that needs to be Pre-Medicated before the dental visit?  Please see our Pre-Medication Notification Form to assist you in communicating this to us in a timely manner.
  • All Parents are sent home Letters explaining the Dental Treatment if they are unable to come to the School the day of the Dental Visit. Click here to view our Letters Home to the Parents.  In Spanish.
  • For the Springfield area, please download a copy of the BEST parent letters.
  • You may also need an extra BEST enrollment letter.