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Birth-5 Health Form.pdf

04605c_401a9426b54d4409ad3812f99d10d70f.pdf
Preview of Birth-5 Health Form
🔗 Source: brightbeginningsenfield.com
📊 Size: 256 KB
👤 Author: Knutson, Stephanie
⬇️ Downloads: 209

Summary

The State of Connecticut Department of Education's Early Childhood Health Assessment Record is a form for parents or guardians to provide information about their child's health needs for early childhood providers. The form is divided into two parts: Part I for parents or guardians to complete, and Part II for healthcare providers to complete. Part I asks about the child's health insurance, dental insurance, and HUSKY insurance, as well as any health concerns, allergies, or medical conditions. Parents or guardians are also asked to provide information about their child's primary healthcare provider, dentist, and any medications their child takes. Part II is for healthcare providers to complete and includes a physical examination, screenings for vision, hearing, and anemia, and an assessment of the child's developmental and chronic disease status. The form also includes an immunization record and a section for healthcare providers to indicate if the child has any special health needs or requires intervention.

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Description

The State of Connecticut Department of Education's Early Childhood Health Assessment Record is a form for parents or guardians to provide information about...

Technical Information

  • File Format: PDF
  • File Size: 256 KB
  • Pages: 3
  • Language: EN
  • Author: Knutson, Stephanie
  • Total Downloads: 209
  • Last Updated: 3 days ago

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