Get Health Assessment Form

The Health Assessment Form is a crucial document required by California law for children entering public school. This guide provides step-by-step instructions on how to complete the form online, ensuring your child meets their oral health assessment requirement.

Follow the steps to fill out the Health Assessment Form online.

1. Click ‘Get Form’ button to obtain the form and access it in your preferred online platform.
2. Begin by completing Section 1 as a parent or guardian. Input your child's first name, last name, date of birth, gender, race/ethnicity, school name, grade, and teacher details. Ensure to provide accurate information to avoid delays in processing.
3. Proceed to Section 2, which must be filled out by the dental professional. This section includes the assessment date and questions regarding visible caries and fillings. The dental professional will also indicate the treatment urgency based on the assessment.
4. If you need to request an exemption from the oral health assessment requirement, complete Section 3 by providing the necessary details and checks based on your specific circumstances. Be sure to include your child's insurance information if applicable.
5. After completing all sections, review the entire form for accuracy. Obtain the necessary signatures where required, including the dental professional's signature in Section 2 and your signature as a parent or guardian in Section 3.
6. Finally, save any changes, and you may choose to download, print, or share the completed form as needed.

Complete your Health Assessment Form online today to ensure your child's health assessment requirement is met.