| 45 Day Screening Parent Notice |
Health |
To notify parents regarding different types of screening the child will be tested on. |
| Child Accident Report Form / Forma Para Reportar Accidentes del Niños |
Health |
Complete when child gets hurt in classroom or playground |
| Child Health History/ Historia del Desarrollo de Salud del Niño |
Health |
Health form in Enrollment Packet |
| CHILDPLUS Monitoring Form |
Health |
1/3 Sheet for Tracking Health Services |
| Consent for Blood Lead Screen |
Health |
Form Parent Must Sign to Allow DACHS to performt a Lead Test on Child |
| Contagious Illness at Head Start Center / Enfermedades Contagiosas a Centro de Head Start |
Health |
Informs Parents of a Contagious Illness at a Head Start Center |
| Daily Safe Environments |
Health |
Monitoring Checklist |
| Daily Sensory Health Check |
Health |
Monitoring Checklist |
| Declination Statement for Health Services/ Declaracion de Declinacion Para services de salud |
Health |
Parents complete if children do not have a physical and/or dental exam |
| Dental Exam- Medical Exam Reminder/ Examen Dentista- examen Fisico Recordatorio |
Health |
Letter to parents |
| DACHS-Dental-form-2020-21 |
Health |
To be completed by dentist |
| Diet Plan for Meals at Child Care |
Health |
To be completed by Dr. |
| EHS-Daily Sensory Health Check |
Health |
Monitoring Checklist |
| EHS&HB Health Screening ENGL-SPAN 2019 |
Health |
45 day Screening Form |
| Follow Up to Dental Exam Form |
Health |
To be completed by Dr |
| Follow Up to Physical Exam Form |
Health |
To be completed by Dr. |
| Health Box Inventory |
Health |
Health Supplies provided to the Direct Service Staff at the start of the year |
| Health Monitoring Tool for Beginning of School Year |
Health |
Monitoring form |
| Health Services Objectives / Objectivos de Servicos de Salud |
Health |
Goals of the Health content area |
| Healthy Habits for Happy Smiles |
Health |
|
| Hearing Vision Screening |
Health |
45 day completed mandate screening |
| Height/ Weight Growth Chart Summary Form |
Health |
45 day form used by FOW's |
| HS Oral and Health Form |
Health |
Head Start Oral Health Form |
| Immunization Reminder for Parents |
Health |
Reminder for Parents that Child Needs Immunizations |
| Individual Health Care Plan- IHCP |
Health |
Complete this form with parent, FOW, teacher & Specialist |
| Lead Risk Questionnaire / Questionario Sobre Los Riesgos del Plomo |
Health |
Form for parents to fill out in Enrollment Packet |
| Medically Fragile Release (4) |
Health |
To be completed by Dr. complete with signature and date |
| Medication Monitoring Form (3) |
Health |
To monitor childs reaction to RX |
| Monthly First Aid Inventory |
Health |
Monitoring form for First Aid Kit supplies. To be filled out monthly and submitted to the Health Specialist for review & replenishing supplies. Can also be submitted when items are needed during the month |
| Newborn Visit |
Health |
Information and tips for Early Head Start staff |
| No Live Lice Policy / Poliza Contra Los Piojos Vivos |
Health |
Parent Notice |
| Head Lice Treatment / Tratamiento para Piojos en la Cabeza |
Health |
Head Lice Treatment |
| Parent/ Guardian Permission to Reveal or Obtain Confidential Information/ Permiso Para Dar u Obtener Informacion Confidencial |
Health |
Parent Notice |
| Parent/ Guardian Written Consent for Medication Administration (2) / Consentimiento to Escrito Para Padres/ Guardianes Para La Administracion de Medicamientos |
Health |
Form for parent to give staff permission to administer RX |
| Parent Notice of Height/ Weight Form/ Noticia Para Padres de Statura y Peso |
Health |
Height and Weight to give parents a choice of services |
| Permission to Release Dental and Physical Exam Form / Consentimiento para Exámenes Dentales y Físicos |
Health |
Form for parents to sign in Enrollment Packet |
| Physical Exam form 2021 |
Health |
To be completed by Dr. |
| Physician's Orders for Prescribed Medicines/Other (1) / Orden para el Médico por Medicinas/Otro(1) |
Health |
To be completed by Dr. to administer RX and accompanied by the Medically Fragile Release(4) with Dr. signature & date” |
| Reminder and Release Form for Blood Lead Screen Test and Hemoglobin/Hematocrit Test |
Health |
Reminder/Release for Blood Lead Screen Test and Hemoglobin/Hematocrit Test |
| Schedule for Cleaning, Sanitizing, and Disinfecting |
Health |
To meet Federal and Licensing Standards |
| Toilet Training Calendar/ Calendario de Entrenamiento Del Baño |
Health |
Assist parent w/toilet training process |
| Toilet Training Letter to Parents/ Carta Para Padres/ Toilet Training Plan/ Plan de Entrenamiento / Parents Toilet Training Agreement/ Contracto de Entrenamiento Para Los Padres |
Health |
Assist parent w/toilet training process |
| Vaccine Requirements |
Health |
State of New Mexico Vaccine Requirements |
