Get Headstartphysicalexam.doc - Chw 2020-2026

Filling out the HeadStartPhysicalExam.doc - Chw form is an essential step in ensuring the health and well-being of children in the Head Start program. This guide provides clear instructions to help users navigate the form efficiently.

Follow the steps to complete the form accurately.

1. Click the ‘Get Form’ button to obtain the form and open it in your preferred document editor.
2. Begin by filling in the Head Start Center's name at the top of the form. This information identifies the specific program the child is attending.
3. Next, enter the child’s name and birthdate. Ensure to double-check the spelling of their name and the correct date format.
4. Provide the child’s Social Security Number and select their sex by marking the appropriate box (M or F).
5. Fill in the child’s address and phone number. Accurate contact information is crucial for future communications.
6. In the section labeled 'Dear Doctor: Please Read,' you will see instructions for the physician to complete the physical examination. This part does not require any input from you.
7. The doctor will complete their observations starting with the child's height, weight, and blood pressure, as well as assessments for vision and hearing.
8. Next, there is a field for the doctor to note any suspected physical, emotional, or language delays. This will require the physician's input based on their examination.
9. The hematocrit and lead results will also be filled in by the physician after testing.
10. In the 'Region' section, the doctor will mark either 'Normal' or 'Abnormal' for various health indicators, including skin, EENT, heart, lungs, abdomen, neuromuscular, and genitalia, along with any additional comments.
11. Indicate if the child is taking any prescribed medication by marking 'Yes' or 'No.' If 'Yes,' describe the type and dosage.
12. Next, answer if there are any dietary restrictions in the same manner, providing details if necessary.
13. Complete the immunization history section by listing the dates for DTP, OPV, MMR, HIB, and any other vaccines received.
14. Finally, the physician will need to fill in their name, phone number, address, and the date before signing the form.
15. Once the form is completed, save the document for your records. You can also download, print, or share it as required.

Complete the HeadStartPhysicalExam.doc - Chw online and ensure your child's health examination is processed without delay.