Service Provided by:
At Home Dental

Agreement Form

Supervised Toothbrushing Scheme - Southwest

We are excited and pleased that you have agreed to take part in such an important scheme, which will bring lasting health benefits to participating children in your setting.

We want to support you in every way we can to ensure the scheme is easily carried out and any issues are resolved quickly.

As part of the funding for the scheme we are required to have a memorandum of understanding between the school and ourselves , so you can understand the expectations between the schools and ourselves. Please read through this brief form and return it to us signed and we look forward to working with you over the upcoming years.

Please include on this form your nominated Oral Health Care Lead / Contact (this can be changed later).

At Home Dental will:
Engaged childcare staff will:

Brushing together for healthy smiles

If, in the unlikely event, the school wishes to opt out of the scheme, we will be happy to comply
with your requests and ensure we collect any unused supplies.

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School:

Printable form – if you cannot fill out the online form for any reason, please print and complete this PDF and email a copy to info@bigbrushclub.co.uk, please download our form here - click here.

School Address

Brushing together for healthy smiles

www.bigbrushclub.co.uk

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Contact Agreement Form

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