This page contains forms used in the Seal Indiana program.


  • The Consent for treatment form describes the services that Seal Indiana provides at schools and community health centers throughout Indiana. It must be completed and signed by a parent/guardian to enable a child to participate. This form is available in Spanish.
  • The Report to parents/Guardians is completed by Seal Indiana following an examination and preventive dental care and includes information on the oral health of the child. This form is available in Spanish.