Follow the steps to complete the form successfully.

1. Click ‘Get Form’ button to obtain the form and open it for completion.
2. In Part I, fill out the required information as the parent or guardian. Provide your child's last name, first name, middle initial, birth date, school, and address, including city and zip code.
3. Indicate whether you want the medical provider to complete Part II by checking the appropriate box.
4. Part II will be filled out by the medical provider. Ensure your child receives the necessary health checkup where the provider will record height, weight, BMI percentile, and date of exam. Collect your provider’s name, address, and telephone number.
5. The medical provider will complete tests and evaluations, including health development history, physical examination, nutritional evaluation, vision screening, audiometric screening, blood test for anemia, urine dipstick, and dental screening.
6. Ensure the providers confirm whether your child has a completed and updated yellow California immunization record.
7. If there is any additional health information that the provider or parents wish to share, it can be completed in Part III.
8. If the parent or guardian does not want the child to receive a medical examination, they must indicate this on the waiver section and provide a reason.
9. Finally, sign and date the form to authenticate it before submitting it to the school.
10. After completing the form, you may save your changes, download a copy, print it out, or share it as needed.

Take the necessary steps today to complete your child's School Entry Health Checkup Requirement online.