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HEALTH

 

   Quick Links to Sections on this Page:  
 

 

 Classroom Health Routines

     
 Guidelines & Procedures      Forms  
 Classroom Health Routines 
 "Block the Sun, Not the Fun" Flyer: English   Spanish   Arabic   Vietnamese

 
   Daily Activity Chart for Infants and Toddlers
 The Nit-Picking - Who Does What Work Chart
 Sunscreen Application Record Form - Bulk
 Sunscreen Authorization Form - Bulk Container 
 Sunscreen Authorization Form - Individual Container

 Health Enrollment — General

     
 Guidelines & Procedures      Forms  

 Immunization Requirements Procedure  Revised 12/31/2019
 Authorization to Release Confidential Health Information Procedure
 Food Allergies/Intolerance/Special Dietary Needs Procedure
 Dietary Accommodations and Food Preferences Flowchart 
 Health/Nutrition Enrollment Flowchart

   Health History (1-5 Years) 
 Health History Tool (1-5 Years) 
 Health History (0-12 months) 
 Health History Tool (0-12 months) 
 Certificate of Immunization Status (CIS) Form:   English  DOH Revised 11/2019
 Certificate of Exemption (COE) Form:   English  DOH Revised 10/2019
 Authorization to Release and Exchange Confidential Health Information
 Authorization to Release Immunization Records:  English  Spanish
 Emergency Treatment and Consent Form   English  
** Also see the "Child Enrollment" section on the EDUCATION - OVERVIEW page **
** Also see the "Enrollment" section on the ERSEA page **

 Health Enrollment — Well Child

     
 Guidelines & Procedures      Forms  

 When I Give Consent, It Means I Agree
 Physical and Dental Exams Procedure 
 Lead Letter to Providers
 Declining Early Learning Health Services 
 Well Child Exam Tool

   Susceptible List (Exempt Children) Form 
 Susceptible List (Need Follow-Up) Form 
 Lead / Hematocrit / Hemoglobin Fax Cover Sheet
 Medical/Dental Exam Letter
 

 Child Health Plans

     
 Guidelines & Procedures      Forms  
 Child Health Plans Procedure  
 Child Supplemental Food Plan Procedure 
 Diabetes Management in the Classroom
 
  Health Related:
 Child Health Plan and Provider Orders — Respiratory Disorder 
 Child Health Plan and Provider Orders — Seizure Disorder 
 Child Health Plan and Provider Orders — Skin Condition 
 Child Health Plan and Provider Orders — Non-Food Allergies  
 Child Health Plan and Provider Orders — Reflux Infants and Toddlers 
 Child Health Plan and Provider Orders — Other Health Conditions 


Nutrition Related:
 Child Health Plan and Provider Orders — Dietary Accommodations - Food Allergies/Intolerances 
 Child Supplemental Food Plan  
 Parent/Guardian Request for Milk Substitute  
 

 Health & Growth Screenings

     
 Guidelines & Procedures      Forms  

 Preschool Height and Weight Screenings Procedure 
 Vision and Hearing Screenings Procedure 
 Instructions for 45-Day Screening Results - HS & ECEAP 
 
Instructions for 45-Day Screening Results - EHS  
 
Growth Assessment Procedure (0-3 years) 

   Health and Developmental Screening Results Form - HS & ECEAP 
 
Health and Developmental Screening Results Form - EHS  

 Vision Screening Referral Letter (3-5 Years)
 Hearing Screening Referral Letter 
 Diagnostic Follow-up Form
 Vision Summary (0-12 months) 
 18 Vision Development Milestones from Birth to Baby's First Birthday 
Spring Growth Results Form


** Also see the SCREENING & ASSESSMENT page **

 Medications — General

     
Guidelines & Procedures      Forms  

 Medication Administration Procedure 

 
   Medication Administration Parent Letter Form 
 Parent/Guardian Authorization for Medication Administration at School and Medication Administration Record Form 
 Medication Administration Error Record
 Provider Orders for Over the Counter Medication at School Form 
 Provider Orders for Medication at School Form — Supplemental 

 

 Communicable Diseases & Health Notices

     
Guidelines & Procedures     Forms  

 Exposure to Communicable Diseases Procedure  
 

 
 

 EXPOSURE NOTICES COVER SHEET - Important Notices to Families Cover Sheet
 ("This is an important notice. Please have it translated.")

Cambodian Korean Punjabi Russian Somali Spanish Vietnamese


 EXPOSURE NOTICES TO FAMILIES

 Bacterial Meningitis: English Arabic Russian Somali Spanish Vietnamese
 Chicken Pox: English Arabic Russian Somali Spanish Vietnamese
 Cold Sores/Fever Blisters: English Arabic Russian Somali Spanish Vietnamese
 Conjunctivitis (Pink Eye): English Arabic Russian Somali Spanish Vietnamese
 Cytomegalovirus (CMV): English Arabic Russian Somali Spanish Vietnamese
 Diarrheal Illness/
 Stomach Flu:
English Arabic Russian Somali Spanish Vietnamese
 Fifth Disease
 (Erythema Infectiosum):
English Arabic Russian Somali Spanish Vietnamese
 Hand, Foot, and
 Mouth Disease:
English Arabic Russian Somali Spanish Vietnamese
 Head Lice: English Arabic  Russian  Somali  Spanish  Vietnamese
 Impetigo: English Arabic Russian Somali Spanish Vietnamese
 Influenza: English Arabic Russian Somali Spanish Vietnamese
 Molluscum Contagiosum: English Arabic Russian Somali Spanish Vietnamese
 Mononucleosis: English Arabic Russian Somali Spanish Vietnamese
 MRSA
 (Methicillin-Resistant
 Staphyloccus Aureus):
English Arabic Russian Somali Spanish Vietnamese
 Pinworms: English Arabic Russian Somali Spanish Vietnamese
 Reyes Syndrome following
 Chicken Pox or Influenza:
English Arabic Russian Somali Spanish Vietnamese
 Ringworm: English Arabic Russian Somali Spanish Vietnamese
 Scabies: English Arabic Russian Somali Spanish Vietnamese
 Scarlet Fever: English Arabic Russian Somali Spanish Vietnamese
 Strep Throat: English Arabic Russian Somali Spanish Vietnamese
 Whooping Cough/Pertussis: English Arabic Russian Somali Spanish Vietnamese

 

 Pregnancy & Postpartum

     
      Forms  
 Maternal Depression Screening Procedure
 Pregnancy/Postpartum Services Checklist
   Pregnancy Health History
 
Maternal Depression Screening:   English   Spanish
 Two-Week Postpartum and Newborn Visit Summary

 

 Dental

     
Guidelines & Procedures     Forms  
 Dental Intervention Procedure
 Dentist and Hygienist Classroom Screening Procedure 


 
 

 Dental Examination Report
 Dental Screening Consent Form - SeaMar Community Health:
     English   Spanish   
 Dental Screening Evaluation Form - SeaMar Community Health:   English   Spanish
 Dental Screening Consent Form - Community Health Center:   English   Spanish
 Dental Screening Evaluation Form - Community Health Center:   English   Spanish
 Community Medical/Dental Resources Parent Notices - Multiple Languages

 Animals in the Early Learning Environment

     
Guidelines & Procedures     Forms  
 Animals in the Early Learning Environment Procedure
 
   Parent Consent for Animal(s) in the Early Learning Environment
 Parent Notification for Service Animal(s) in the Early Learning Environment