Ct Child Health Assessment Form

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FAQ?

How do I Complete my Child’s state of Connecticut Health Assessment?

The “blue” State of Connecticut Health Assessment form must be completed by your child’s physician with all required immunization dates noted. The front of this form is to be completed by the students’ parent or legal guardian. Completed physicals should be given to your child’s school nurse.

What is the Connecticut Department of Public Health?

Department of Public Health forms for the protection and improvement of the health and safety of the people of Connecticut. Find the latest data, health guidance, and resources on how to navigate the COVID-19 pandemic. Testing is available in many locations throughout Connecticut.

What do you need to know about health assessment records?

Health Assessment Record To Parent or Guardian: In order to provide the best educational experience, school personnel must understand your child’s health needs. This form requests information from you (Part I) which will also be helpful to the health care provider when he or she completes the medical evaluation (Part II).

How to provide the best educational experience for your child’s health needs?

To Parent or Guardian: In order to provide the best educational experience, school personnel must understand your child’s health needs. This form requests information from you (Part 1) which will also be helpful to the health care provider when he or she completes the medical evaluation (Part 2) and the oral assessment (Part 3).