Brooker Memorial Pediatric Dental Center Announces 2022/2023 Dental Program Dates!
Dear Region One, Torrington Public Schools and Botelle School Parents,
Medical and permission forms are below, on your school website, or by requesting a paper copy from your school nurse. Spanish versions are also available. Please fill out ALL requested information asked on the following forms AND sign the required areas.
*** DUE TO THE DELAYED START TIME OF THIS PROGRAM, WE ARE ASKING THAT IF YOUR CHILD HAS HAD DENTAL CARE WITHIN THE LAST 6 MONTHS THAT YOU DO NOT SIGN UP FOR THIS PROGRAM***
For Region One Public School Students
Location: Sharon Center School
Region One Medical & Permission Form (English PDF)
Region One Médica y Formulario De Permiso (Español PDF)
For Torrington Public School Students
Torrington Medical & Permission Form (PDF)
Torrington Medical & Formulario De Permiso (Español)(PDF)
For Botelle School Students
Location: 128 Greenwoods Rd E, Norfolk Historic District, CT 06058
Botelle Medical & Permission Form (PDF)
As always, we will be adhering to our strict dental sterilization procedures. All of our school settings are licensed by the State of Connecticut Health Department.
We look forward to our return to school!
Debra Ravlin, RDH
(860) 489-1328 ext. 0