Miles of Smiles, Ltd.

Public Forms for Download

• Attention Parent Letter  (Download: English or  Español)
• Permission Slip
• Fill Out Online:
  English
  Español
• Download: English,  Español,  Français,  Polski,  Russian,  Arabic,  Vietnamese,  Gujarati, or  Ukrainian
• County specific Permission Slips
• CPS/Cook County  (Download: English or  Español)
• CPS/Cook Take Home  (Download: English or  Español)
• Restorative Consent  (Download: English or  Español)
• New!! Silver Diamine Fluoride (SDF)  
• SDF Information (Download: English)
• SDF Consent Form (Download: English)
• MOS Exam Form  (Download: English)
• Take Home  (Download: English or  Español)
• State Mandated Exam Form  (Download: English or  Español)
• HIPPAA compliance  (Download: English)
• Fluoride Varnish disclaimer regarding tree nut allergies  (Download: English)