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/Institutions/University-of-Maryland-School-of-Dentistry/json/Clinic-Manual/Clinic-Manual-local.json

/Institutions/University-of-Maryland-School-of-Dentistry/json/Clinic-Manual/Clinic-Manual.json

Clinical and Educational Community Service Events Procedure

Subject: I. Academic – A. Student Affairs

Effective Date: 9/10/15

Reviewed and/or Revised: 09/15/2016, 05/26/2017, 09/01/2017, 07/25/2018, 08/25/2021, 02/29/2024, 01/30/2025, 08/01/2025

1. CLINICAL - For clinical community service outreach activities and health fairs that involve screenings, fluoride varnish, etc., a School of Dentistry Maryland State Licensed Dentist Faculty must oversee this event. The event must be located in Maryland. The following is needed two (2) weeks prior to the event for Liability Insurance reasons:  
   1. Student Activities Information and Guidelines form titled 'Information and Guidelines - Professional Liability Insurance Coverage for Student Volunteer Events with Clinical Activity (PDF)'  – needs to be completed and sent to Elyse Markwitz, the Director of Medical Credentialing and Quality Assurance at least two (2) weeks prior to the outreach clinical event for review and to obtain the Associate Dean of Clinical Affairs’ approval and signature.
   2. Dental Screening Consent form – each patient/participant obtaining a screening is to complete and sign the form. Original forms are kept on file by the overseeing Dentist Faculty’s Department and copies are sent to the Director of Medical Credentialing and Quality Assurance. 
   3. Template Sign in Sheet and Consent - The date on the form will need to be changed and reference the name of the outreach event. Each patient/participant obtaining a screening must sign in. Original sign in sheets and consents are kept on file by the overseeing Dentist Faculty’s Department and copies are sent to the Director of Medical Credentialing and Quality Assurance. 
2. EDUCATIONAL - For educational community service, virtual programs, or outreach activities that do not involve screenings, fluoride varnish, etc. a UMSOD Dentist Faculty or Faculty does not need to be overseeing the event. The following is needed two (2) weeks prior to the event: 
   1. Complete the following Educational Form titled 'Student Education Activities Form: NON- CLINICAL/EDUCATIONAL ONLY (PDF)'. The sponsoring UMSOD Faculty provider and the faculty provider’s Chairperson both sign this form. 
   2. Submit the signed form to Elyse Markwitz, Director of Medical Credentialing and Quality Assurance at emarkwitz@umaryland.edu.
3. A list containing the names of the students’ needs to be submitted to the Director of Medical Credentialing and Quality Assurance two (2) weeks prior to the event stating what the students will be doing at the event. 
4. Faculty is to notify students if they will NOT be assisting at the event and doing other volunteer tasks (such as: setting up, etc.)