Preventive Services Program Forms Thank you for participating in the Preventive Services Program! PSP Event Steps: 1. PSP Planning Guide 2. PSP Checklist for Event Preparation & Follow Up 3. Parental Consent Form English 4. Parental Consent Form Spanish 5. PSP Order Form 6. Receiving Ordered PSP Supplies 7. PSP Event Tracking Form 8. Oral Health Screening Results Form English & Spanish 9. Fluoride Varnish Home Care Instructions English 10. Fluoride Varnish Home Care Instructions English & Spanish 11. Cover Sheet & Mailing Instructions 12. Returning Paper PSP Screening Forms 13. Submit Mandatory PSP Event Report PSP Screening Form (Emergency Use Only) Additional Resources for PSP Events Locate Your Oral Health Consultant PSP Screener & Volunteer Trainings Online PSP Screening Form (Save the paper & shipping) Online PSP Screening Form Instructional Video Printable Online PSP Screening Form Instructions Additional Resources Material Safety Data Sheet for NovaBright Fluoride Varnish PSP Event Set-up Floor Plan Sample Set-up Volunteer Recruiting Letter – Dental Professionals
