Library: Policy

317:30-5-708. Parental consent requirements

Revised 11-4-22

        Individual providers at a mobile or portable dental unit shall not perform any service on a minor without having obtained, prior to the provision of services, a signed, written consent from the minor's parent or legal guardian, that includes, at a minimum, the:

(1) Name of the dental group and/or dentist providing the dental services at the mobile and/or portable dental unit; 

(2) Permanent business mailing address of the dental group and/or dentist providing the dental services at the mobile and/or portable dental unit;

(3) Business telephone number of the dental group and/or dentist providing the dental services at the mobile and/or portable dental unit. This telephone number must be available for emergency calls;

(4) Full printed name of the child to receive services;

(5) Child's SoonerCare Member ID number; and

(6) An inquiry of whether the child has had dental care in the past twelve (12) months and if the child has a dental appointment scheduled with his/her regular dentist. If applicable, parent should list the name and address of the dentist and/or dental office where the care is provided.