GKAS Program Planning Toolbox
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- Program Planning Guide
- Program Promotion Guide
- Legal, Insurance and Risk Management Considerations Guide
- Additional Resources
Program Planning Guide
Have you planned an access to care event in the past or is this a new activity for you? The keys to success are organization, planning, execution, publicity and evaluation. The Program Planning Guide is here to help you sort everything out.
- Program Planning Guide (PDF/1.85MB)
- Community Coalition-Building and Identifying Qualified Children for GKAS (PDF)
- Sample Data Collection Form (PDF)
- Data Collection Form (PDF)
Program Promotion Guide
Whether you are part of a planning group or handling and entire event yourself, it’s important to promote your GKAS event to the media. The following materials should help guide you when it comes to contacting the local media about your event.
- Program Promotion Guide (PDF/1.49MB)
- Selecting a Spokesperson (PDF)
- Working with the Media (PDF)
- Talking Points for Give Kids A Smile (PDF)
- Sample Media Alert (PDF)
- Sample Radio Public Service Announcement (PDF)
Legal, Insurance and Risk Management Considerations Guide
As with any access to care program, GKAS raises legal, insurance and risk management considerations. The good news is that these considerations can be managed with thoughtful planning.
Notice of Privacy Practices
This notice describes how health information about patients may be used and disclosed and how to get access to this information.
Acknowledgement Form
This form acknowledges that the Notice of Privacy Practices was given and read by the patient.
Give Kids A Smile® Logo
The Give Kids A Smile logo is available to dental societies for their use in promoting local events. If you are a dental society staffer, go to the Dental Society Resources Web site.
If you are serving as a chairperson of a local event and need the GKAS logo for a banner, handout or mailing that promotes the Give Kids A Smile event, please complete the request form below and e-mail it to gkas@ada.org. We will review and respond to your request as quickly as possible.
ADA Caries Risk Assessment Forms
- Download Instructions (PDF)
- Caries Form (Patients Ages 0-6 Years) (PDF)
- Caries Form (Patients Over 6 Years ) (PDF)
Additional Resources
Additional resources include sample forms, fliers, letters and a House Resolution.
Sample Forms
- Sample Data Collection Form (PDF)
- Data Collection Form (PDF)
- Sample Dental Examination Waiver Form (PDF)
- Sample Patient Waiver Form (PDF)
- Sample Photo Permission Release (PDF)
GKAS Marketing and Promotion Forms
English:
- 2013 Fill-in Flyer (PDF)
- 2013 Fill-in Flyer Instructions (PDF)
- 2013 Fill-in Poster (PDF)
- 2013 Fill-in Poster Instructions (PDF)
- 2013 Certificate (PDF)
- 2013 Certificate Instructions (PDF)
Spanish:
- 2013 Fill-in Flyer (PDF)
- 2013 Fill-in Flyer Instructions (PDF)
