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CHILD CARE PHYSICAL EXAMINATION Childs Full Name Age Height Weight Vision: Eye Correction required Hearing: Normal Yes Abnormal EENT Teeth Neck Chest Lungs No Date of Exam BP Glasses P Contact Lens.

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How to fill out the Child Care Physical Exam Form online

Filling out the Child Care Physical Exam Form online is a straightforward process that ensures your child's health information is accurately recorded. This guide will help you navigate each section of the form with ease, highlighting the necessary details required from you and your child's physician.

Follow the steps to complete the form accurately.

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Begin by entering your child's full name in the designated field, followed by their age. Ensure all spelling is correct to avoid any inconsistencies.
  3. Fill in your child's height and weight, which are essential for assessing their growth and development.
  4. In the vision section, indicate if any eye correction is required and check the corresponding box for hearing status; this includes options for normal and abnormal vision.
  5. Complete the physical examination details, including the condition of the ears, nose, throat (EENT), teeth, neck, chest, lungs, heart, abdomen, hernia, extremities/skin, posture/spine, genitalia, rectum/anus, and neuromuscular system.
  6. Input the date of the exam and record the blood pressure reading alongside whether glasses or contact lenses were used, or if the child was not tested.
  7. If additional tests such as hemoglobin or hematocrit, tuberculin screening, sickle cell screening, developmental testing, or lead screening were conducted, note the results in the appropriate sections.
  8. Document any known medical conditions that your child is being treated for and list any allergies, as well as additional health information that may be pertinent.
  9. Indicate whether the child is physically and/or emotionally able to participate in the program by checking the corresponding box.
  10. Sign the form as the physician or designee, ensuring to include the date for record-keeping.
  11. As a parent, complete the section regarding any diseases the child has had and any special health needs.
  12. Once all sections are filled out, review the entire form for accuracy, then save changes, download, print, or share the form as needed.

Start filling out the Child Care Physical Exam Form online now to ensure your child's health is well-documented.

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Contact support

If you suspect child abuse or neglect, call our toll-free hotline at 1-800-392-3738. Our team will be available to help 24 hours a day, 7 days a week.

If you suspect child abuse, neglect, or exploitation at a child care facility in Missouri, contact the Child Abuse and Neglect Hotline at 1-800-392-3738.

DESE child care sanitation inspectors conduct thorough inspections to ensure the health and safety of children in care. Inspectors evaluate cleanliness, facility maintenance, water and sewer services, hygiene, food protection, diapering, and other various procedural issues that promote a healthy environment.

If you suspect child abuse, neglect, or exploitation at a child care facility in Missouri, contact the Child Abuse and Neglect Hotline at 1-800-392-3738.

Missouri law requires that a CD Children's Service Worker initiate an investigation/family assessment within 24 hours of the receipt of the report, unless the incident relates to educational neglect only, in which case an investigation/family assessment must be initiated within 72 hours.

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