Get Cys Health Assessment Form

Filling out the Cys Health Assessment Form online is an essential step in ensuring that your child's health information is accurately recorded for participation in CYS programs. This guide will provide clear, step-by-step instructions to help you navigate through each section of the form effectively.

Follow the steps to complete the Cys Health Assessment Form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin with Part A of the form, which requires information about the sponsor. Fill in the name of the sponsor, their home and cell phone numbers, and their work address. Ensure to include the sponsor's social security number and their spouse's work phone.
3. Next, provide the child's health information. Include their name, birth date, and answer whether the child has ongoing medical concerns. If yes, explain the circumstances and current status.
4. Indicate whether the child is enrolled in the Exceptional Family Member Program, and provide additional details if applicable.
5. Proceed to the medical history section. For each item listed, indicate 'Yes' or 'No' for conditions such as hospitalizations, allergies, and vision problems. If any items are answered 'Yes,' please provide a detailed explanation.
6. Document ongoing medications, including the name and dosage of each medication, along with any known allergies and their reactions.
7. If completing Part B for a sports physical, medical staff will assess the child. Ensure that all necessary measurements and evaluations are collected, including age, height, weight, blood pressure, and visual acuity.
8. After Part B is filled out by the licensed independent practitioner, assess the recommendations for participation in sports and any restrictions if necessary.
9. Complete Part C by describing any special medical considerations the child may have when participating in CYS programs. Indicate if the child is able to participate in normal CYS programs.
10. Finalize the form with signatures from the parent or guardian on the designated lines. Ensure that the licensed health care professional also provides their stamp and signature.
11. After filling out the form, you can save your changes, download it for your records, print a hard copy, or share it as needed.

Start completing your Cys Health Assessment Form online today to ensure your child's safe participation in programs.