Get Child Carehead Start Health Record Indiana State Form - Fbcindy

This guide provides a comprehensive overview of how to effectively complete the CHILD CARE/HEAD START HEALTH RECORD Indiana State Form - Fbcindy online. Follow these instructions to ensure all fields are accurately filled out and your submission is successful.

Follow the steps to complete the health record form correctly.

1. Press the ‘Get Form’ button to access and open the health record form in the designated editor.
2. Enter the child's name in the spaces provided for 'Last' and 'First' names.
3. Fill in the child's birth date and admission date by writing the month, day, and year in the appropriate fields.
4. Complete the child's street address, city, and zip code.
5. Indicate who the child lives with by writing their name and providing a contact phone number.
6. In the medical history section, check the boxes for any communicable diseases the child has experienced and provide explanations where necessary.
7. List any allergies the child may have, along with any physical limitations or other medical conditions.
8. For the physical examination section, enter the date of the exam and the child's age, and provide information on various health assessments as indicated.
9. Indicate if there are any health conditions that could pose hazards in group settings and the necessary modifications required.
10. Record any prescribed medications or special routines relevant to the child's activities.
11. Complete the history of immunizations, marking the dates for each vaccine indicated.
12. Provide the name and phone number of the physician completing the form, and ensure their signature is included.
13. Refer to the additional notes and instructions section for any final remarks or instructions that may need to be addressed.
14. Once all fields are completed, users can save changes, download, print, or share the health record form.

Complete your health record form online today to ensure your child's health information is accurately submitted.