well child visit forms

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EPSDT & Well Child Visits

Periodicity schedule.

Periodicity Schedule  

TNAAP EPSDT Coding Guide

Well Child Forms

Complete Set of Age Specific Encounter Forms

Lead Screening

• TN Lead Screening and Testing Guidelines
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Well-Child Visits: Parent and Patient Education

The Bright Futures Parent and Patient Educational Handouts help guide anticipatory guidance and reinforce key messages (organized around the 5 priorities in each visit) for the family. Each educational handout is written in plain language to ensure the information is clear, concise, relevant, and easy to understand. Each educational handout is available in English and Spanish (in HTML and PDF format). Beginning at the 7 year visit , there is both a Parent and Patient education handout (in English and Spanish).

For the Bright Futures Parent Handouts for well-child visits up to 2 years of age , translations of 12 additional languages (PDF format) are made possible thanks to the generous support of members, staff, and businesses who donate to the AAP Friends of Children Fund . The 12 additional languages are Arabic, Bengali, Chinese, French, Haitian Creole, Hmong, Korean, Polish, Portuguese, Russian, Somali, and Vietnamese.

Reminder for Health Care Professionals:  The  Bright Futures Tool and Resource Kit, 2nd Edition ​ is available as an online access product. For more detailed information about the Toolkit, visit  shop.aap.org . To license the Toolkit to use the forms in practice and/or incorporate them into an Electronic Medical Record System, please contact  AAP Sales .

Parent Educational Handouts

Infancy visits.

3 to 5 Day Visit

1 Month Visit

2 Month Visit

4 Month Visit

6 Month Visit

9 Month Visit

Early childhood visits.

12 Month Visit

15 Month Visit

18 Month Visit

2 Year Visit

2.5 Year Visit

3 Year Visit

4 Year Visit

Parent and patient educational handouts, middle childhood visits.

5-6 Year Visit

7-8 Year Visit

7-8 Year Visit - For Patients

9-10 Year Visit

9-10 Year Visit - For Patients

Adolescent visits.

11-14 Year Visit

11-14 Year Visit - For Patients

15-17 Year Visit

15-17 Year Visit - For Patients

18-21 Year Visit - For Patients

Last updated.

American Academy of Pediatrics

Family Life

AAP Schedule of Well-Child Care Visits

Parents know who they should go to when their child is sick. But pediatrician visits are just as important for healthy children.

The Bright Futures /American Academy of Pediatrics (AAP) developed a set of comprehensive health guidelines for well-child care, known as the " periodicity schedule ." It is a schedule of screenings and assessments recommended at each well-child visit from infancy through adolescence.

Schedule of well-child visits

• The first week visit (3 to 5 days old)
• 1 month old
• 2 months old
• 4 months old
• 6 months old
• 9 months old
• 12 months old
• 15 months old
• 18 months old
• 2 years old (24 months)
• 2 ½ years old (30 months)
• 3 years old
• 4 years old
• 5 years old
• 6 years old
• 7 years old
• 8 years old
• 9 years old
• 10 years old
• 11 years old
• 12 years old
• 13 years old
• 14 years old
• 15 years old
• 16 years old
• 17 years old
• 18 years old
• 19 years old
• 20 years old
• 21 years old

The benefits of well-child visits

Prevention . Your child gets scheduled immunizations to prevent illness. You also can ask your pediatrician about nutrition and safety in the home and at school.

Tracking growth & development . See how much your child has grown in the time since your last visit, and talk with your doctor about your child's development. You can discuss your child's milestones, social behaviors and learning.

Raising any concerns . Make a list of topics you want to talk about with your child's pediatrician such as development, behavior, sleep, eating or getting along with other family members. Bring your top three to five questions or concerns with you to talk with your pediatrician at the start of the visit.

Team approach . Regular visits create strong, trustworthy relationships among pediatrician, parent and child. The AAP recommends well-child visits as a way for pediatricians and parents to serve the needs of children. This team approach helps develop optimal physical, mental and social health of a child.

More information

Back to School, Back to Doctor

Recommended Immunization Schedules

Milestones Matter: 10 to Watch for by Age 5

Your Child's Checkups

• Bright Futures/AAP Recommendations for Preventive Pediatric Health Care (periodicity schedule)

Monday - Friday - 10:00am - 8:00pm, Weekends - Closed

• Call : 575-332-4633
• Text : 877-733-6131
• Email: [email protected]

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AAP Wellness Check-up Questionnaire Sheets for Parents

AAP Wellness Check-up Questionnaire Sheets for Parents.

American Academy of Pediatrics (AAP) recomended wellness check-up questionnaire Sheets to fill out before your child's well-child care visits.

Download PDFs or view online.

Infancy: Birth thru 9 months pre-visit questionnaires

• Child's Well Visit, 2 to 5 Days: Pre-Visit Questionnaire
• Child's Well Visit, 1 Month: Pre-Visit Questionnaire
• Child's Well Visit, 2 Months: Pre-Visit Questionnaire
• Child's Well Visit, 4 Months: Pre-Visit Questionnaire
• Child's Well Visit, 6 Months: Pre-Visit Questionnaire
• Child's Well Visit, 9 Months: Pre-Visit Questionnaire

Early Childhood: 1 thru 4 years pre-visit questionnaires

• Child's Well Visit, 12 Months: Pre-Visit Questionnaire
• Child's Well Visit, 15 Months: Pre-Visit Questionnaire
• Child's Well Visit, 18 Months: Pre-Visit Questionnaire
• Child's Well Visit, 2 Years: Pre-Visit Questionnaire
• Child's Well Visit, 2 and a Half Years: Pre-Visit Questionnaire
• Child's Well Visit, 3 Years: Pre-Visit Questionnaire
• Child's Well Visit, 4 Years: Pre-Visit Questionnaire

Middle Childhood: 5 thru 10 years pre-visit questionnaires

• Child's Well Visit, 5 Years: Pre-Visit Questionnaire
• Child's Well Visit, 6 Years: Pre-Visit Questionnaire
• Child's Well Visit, 7 Years: Pre-Visit Questionnaire
• Child's Well Visit, 8 Years: Pre-Visit Questionnaire
• Child's Well Visit, 9 Years: Pre-Visit Questionnaire
• Child's Well Visit, 10 Years: Pre-Visit Questionnaire

Adolescence: 11 thru 21 years pre-visit questionnaires

• Child's Well Visit, 11 to 14 Years Early Adolescence: Pre-Visit Questionnaire
• Child's Well Visit, 11 to 14 Years Older Child: Pre-Visit Questionnaire
• Child's Well Visit, 15 to 17 Years: Pre-Visit Questionnaire
• Child's Well Visit, 18 to 21 Years: Pre-Visit Questionnaire

We also provide routine immunizations for children and teens

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Appointments available from 1 to 5pm,   Walk-ins are welcome after 6pm!

• Family Resources
• Provider Info

Welcome to the Well Visit Planner ®

Your child, your well visit.

A quick and free pre-visit planning tool to focus care on your unique needs and goals.

Get started now: Covers all 15 age-specific well visits from your child’s first week of life to age 6

Learn more about creating a family account

Take about 10 minutes to get a personalized Well Visit Guide. Get the best care focused on your child and family’s unique goals and needs.

Do you want to use the WVP with the children and families you serve?

Learn more here!

What is a Well Visit?: Well visits are regular check-ups with your child’s personal doctor, nurse, or other child health professional. At least 15 visits are recommended in the first six years of life when children are growing rapidly. Be sure to stay on track with well visits to help your child and family thrive.

What families like about using the Well Visit Planner (WVP):

• Saves time filling out forms during visits
• Gives you a personalized Well Visit Guide with results specific to your child and family
• Provides easy to read resources on your needs and priorities
• Helps you and your child’s providers focus care on your goals and needs
• Builds confidence that your child’s care meets expert guidelines
• You choose what sections to complete and share.

Three Easy Steps for Using the Well Visit Planner

The Well Visit Planner was created to be used in partnership with your provider. If you have a unique code from your provider, enter it here now:

Enter provider ID code

If you do not have a provider ID code, please continue:

If you already have a family account, login here.

Plan ahead for well visits for all your children up to age 6

Store, save and send your personalized Well Visit Guides at any time

Pause and return to complete WVP sessions within one week

Access and review educational resources specific to your priorities, needs and goals

Please note that using the Well Visit Planner as a guest and without a “provider ID code” means you must download, save and share your Well Visit Guide each time you use the WVP . Your data and Well Visit Guides will NOT be saved for future review.

Important Note: Without a provider ID code you need to share your Well Visit Guide with your child’s provider(s) yourself.

Your personalized Well Visit Guide summarizes your priorities and needs based on the information you shared in the Well Visit Planner.  The guide provides resources about your priorities and gives you example questions to help you discuss your priorities with your child’s provider. Consider these four ways to share your Well Visit Guide with your child’s provider(s).

Save & print

Save to your phone or mobile device

Upload your Well Visit Guide to your Patient Portal

Email your Well Visit Guide to your child's provider

• Sign up for a free family account HERE to save, access, review and share your Well Visit Guides at any time.
• Do you want your Well Visit Guide to be automatically shared with your child's provider(s)? Learn more HERE .

Your Data: The Well Visit Planner is operated on a fully secure platform and your data is not shared with anyone except you and, if you agree, your child’s provider or care team.

What our families are saying!

“It’s helpful to know ahead of time what areas my provider will be checking. It also helps you to get an understanding of the milestones that you want to look out for in your child’s development. The idea that my provider can see what my concerns are before my visit is nice. Best case scenario, they would use the information to bring resources to the start of the visit rather than having to gather them during or after the visit.” (Parent)

“I would recommend the WVP, since it a tool that helps organize and prioritize the medical needs of our children. We can share concerns and our provider can get to know them beforehand. The WVP is a good medical attention guide.” [Parent, translated from Spanish]

“As a mother, I would recommend the use of the Well Visit Planner since it is a tool that can help us be organized with everything we'd like to discuss with the doctors. Also, it gives an overview of the visit.” [Parent, translated from Spanish]

“I really like the WVP, and I believe that it is a really resourceful tool to provide more communication between the provider and families. It is also a great tool to have important information to reference that is specific to the child’s growth and development.” (Parent)

Well Visit Planner: Before Getting Started

Please review and scroll to the bottom before agreeing to the voluntary consent.

VOLUNTARY CONSENT FORM

The purpose of the tool, the Well Visit Planner (WVP), is to enable parents to optimize visit time by focusing on priorities, concerns, and other issues specific to the child and family. The WVP asks parents about their child and family and the kind of topics they want to discuss at their child’s well-child visit. The health care provider can use this information to customize the visit to the needs of the parent and child. Additionally, the tool provides educational information about potential discussion topics based on national recommendations for health care providers.

To use this tool, complete the online Well Visit Planner which should take you about 10 minutes. You will be asked to do the following:

• Agree to the WVP Terms and Conditions.
• You will be asked to voluntarily consent to allow the Child and Adolescent Health Measurement Initiative to mine the de-identified information that you provide in order to analyze and improve the WVP tool.
• Provide basic information about your child who has the upcoming well-child visit.
• Answer a series of questions about your child and family that will help you and your child's health care provider know what they may need to focus on during the visit.
• Pick the topics that you want your child's doctor to address and give you information about at the upcoming visit.
• Receive a "Visit Guide" that you may use at your child's well-visit. This guide highlights the topics you may want to discuss and should be brought to the visit.
• You have the option of creating your own account on the WVP. You can use your account to plan future visits, complete unfinished WVP visits, add other eligible children, and review previous Visit Guides and educational information.

Although we have made every effort to protect your identity, there is a minimal risk of loss of confidentiality. Additionally, you may find that some questions or topics cause you emotional discomfort. You may choose not to answer some of the questions.  The choice is up to you.

You may or may not benefit from using the online Well Visit Planner. However, by completing the online tool, you may improve your child's well-visit and you may receive useful information in partnering with your child's health care provider. Additionally, the answers you provide may help your child's health care provider understand your child and family health so that they can better provide well-child care for you. Finally, your participation may help us learn how to benefit parents and children in the future by providing information to health care providers that will help them improve well-child visits.

Confidentiality

We implement a variety of security measures to maintain the safety of your personal information when you enter or submit answers. We offer the use of a secure server. All supplied sensitive information is housed in our database which is protected through a secure dedicated port which only allows data entry from the tool to our database. The database is protected by having a closed-off port for the SQL Server installation. Only authorized personnel with special access rights to our systems are given access to the data. We are required to keep the information confidential.

The WVP does not collect protected health information or information that can lead to the identification of you or your child. You are asked to provide only two pieces of personally identifiable information: child’s first name (optional) and date of birth. These are not stored in our database. The child’s first name is displayed on the Visit Guide. The date of birth is used to calculate the appropriate upcoming well-visit and present the age-specific questions. That visit (e.g. 4 month or 6 month) is stored in our database rather than the date of birth. If you choose to create an account on the WVP, you have the option to add your child’s first name or nickname to appear on the family dashboard and Visit Guide. This name will be saved on our secure servers.

The email address that you use for registering an account will not be shared with any third parties, nor will your email address be sold or used for purposes other than sharing educational resources or sending updates about the Well Visit Planner. You can unsubscribe if you wish to stop receiving emails from us by sending us an email on [email protected] .

In addition, identifying information connected to your computer (IP address) will not be recorded by the CAHMI at any time. If you choose to download or print your Visit Guide, CAHMI will not be liable for any actions related to your choice to disseminate, distribute or copy the Visit Guide with the name(s) of your child(ren) or any other information contained in the guide.

The Well Visit Planner will store the de-identified information that you provide about your child's health, development, and home environment; along with the priorities you select on a secure server. It will not be possible to link this anonymous information to you or your child. We will use this anonymous information to understand parents' concerns and priorities for their well-child visits. This information may also be combined with other parents’ responses and shared with your child’s provider to help them learn more about families they provide care to and improve well-child care for children and their families.

Access and use the Well Visit Planner is free.

You do not have to use the Well Visit Planner. If you do elect to use the Well Visit Planner, and later change your mind, you may discontinue use at any time. If you do not complete the WVP, there will be no penalty or loss of any benefits to which you are otherwise entitled.

If you have any questions, you may contact us at  [email protected]

Your provider ID code

If your child’s provider has invited you to use their tailored Well Visit Planner, you can enter their ID code below. This ID code is also the text included after “/” in the WVP URL that your child’s provider shared (i.e. www.wellvisitplanner.org/ providerIDcode ).

Your Customized Well Visit Planner

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Well Visit Planner: Voluntary Consent

Your privacy is important to us. Please review our terms and conditions , and consent form , check each box below and click the Continue button below.

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Bright Futures Toolkit ISBN (electronic): 978-1-61002-001-5 Publisher: American Academy of Pediatrics

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Table of Contents

• Bright Futures User Guide and Instructions for Toolkit Implementation Open the PDF Link PDF for Bright Futures User Guide and Instructions for Toolkit Implementation in another window
• Introduction
• Bright Futures Toolkit Summary of Changes
• Bright Futures Previsit Questionnaire: First Week Visit (3 to 5 Days) Open the PDF Link PDF for Bright Futures Previsit Questionnaire: First Week Visit (3 to 5 Days) in another window
• Cuestionario previo a la visita de Bright Futures: Visita de la primera semana (entre 3 y 5 días) Open the PDF Link PDF for Cuestionario previo a la visita de Bright Futures: Visita de la primera semana (entre 3 y 5 días) in another window
• Bright Futures Visit Documentation Form: First Week Visit (3 to 5 Days) Open the PDF Link PDF for Bright Futures Visit Documentation Form: First Week Visit (3 to 5 Days) in another window
• Bright Futures Parent Handout: First Week Visit (3 to 5 Days) Open the PDF Link PDF for Bright Futures Parent Handout: First Week Visit (3 to 5 Days) in another window Data Supplements
• Hojas informativas de Bright Futures para los padres: Visita de la primera semana (entre 3 y 5 días) Open the PDF Link PDF for Hojas informativas de Bright Futures para los padres: Visita de la primera semana (entre 3 y 5 días) in another window
• Bright Futures Previsit Questionnaire: 1 Month Visit Open the PDF Link PDF for Bright Futures Previsit Questionnaire: 1 Month Visit in another window
• Cuestionario previo a la visita de Bright Futures: Visita médica de 1 mes Open the PDF Link PDF for Cuestionario previo a la visita de Bright Futures: Visita médica de 1 mes in another window
• Bright Futures Visit Documentation Form: 1 Month Visit Open the PDF Link PDF for Bright Futures Visit Documentation Form: 1 Month Visit in another window
• Bright Futures Parent Handout: 1 Month Visit Open the PDF Link PDF for Bright Futures Parent Handout: 1 Month Visit in another window
• Hojas informativas de Bright Futures para los padres: Visita médica de 1 mes Open the PDF Link PDF for Hojas informativas de Bright Futures para los padres: Visita médica de 1 mes in another window
• Bright Futures Previsit Questionnaire: 2 Month Visit Open the PDF Link PDF for Bright Futures Previsit Questionnaire: 2 Month Visit in another window
• Cuestionario previo a la visita de Bright Futures: Visita médica del 2 mes Open the PDF Link PDF for Cuestionario previo a la visita de Bright Futures: Visita médica del 2 mes in another window
• Bright Futures Visit Documentation Form: 2 Month Visit Open the PDF Link PDF for Bright Futures Visit Documentation Form: 2 Month Visit in another window
• Bright Futures Parent Handout: 2 Month Visit Open the PDF Link PDF for Bright Futures Parent Handout: 2 Month Visit in another window
• Hojas informativas de Bright Futures para los padres: Visita médica del 2 mes Open the PDF Link PDF for Hojas informativas de Bright Futures para los padres: Visita médica del 2 mes in another window
• Bright Futures Previsit Questionnaire: 4 Month Visit Open the PDF Link PDF for Bright Futures Previsit Questionnaire: 4 Month Visit in another window
• Cuestionario previo a la visita de Bright Futures: Visita médica de 4 mes Open the PDF Link PDF for Cuestionario previo a la visita de Bright Futures: Visita médica de 4 mes in another window
• Bright Futures Visit Documentation Form: 4 Month Visit Open the PDF Link PDF for Bright Futures Visit Documentation Form: 4 Month Visit in another window
• Bright Futures Parent Handout: 4 Month Visit Open the PDF Link PDF for Bright Futures Parent Handout: 4 Month Visit in another window
• Hojas informativas de Bright Futures para los padres: Visita médica del 4 mes Open the PDF Link PDF for Hojas informativas de Bright Futures para los padres: Visita médica del 4 mes in another window
• Bright Futures Previsit Questionnaire: 6 Month Visit Open the PDF Link PDF for Bright Futures Previsit Questionnaire: 6 Month Visit in another window
• Cuestionario previo a la visita de Bright Futures: Visita médica de 6 mes Open the PDF Link PDF for Cuestionario previo a la visita de Bright Futures: Visita médica de 6 mes in another window
• Bright Futures Visit Documentation Form: 6 Month Visit Open the PDF Link PDF for Bright Futures Visit Documentation Form: 6 Month Visit in another window
• Bright Futures Parent Handout: 6 Month Visit Open the PDF Link PDF for Bright Futures Parent Handout: 6 Month Visit in another window
• Hojas informativas de Bright Futures para los padres: Visita médica del 6 mes Open the PDF Link PDF for Hojas informativas de Bright Futures para los padres: Visita médica del 6 mes in another window
• Bright Futures Previsit Questionnaire: 9 Month Visit Open the PDF Link PDF for Bright Futures Previsit Questionnaire: 9 Month Visit in another window
• Cuestionario previo a la visita de Bright Futures: Visita médica de 9 mes Open the PDF Link PDF for Cuestionario previo a la visita de Bright Futures: Visita médica de 9 mes in another window
• Bright Futures Visit Documentation Form: 9 Month Visit Open the PDF Link PDF for Bright Futures Visit Documentation Form: 9 Month Visit in another window
• Bright Futures Parent Handout: 9 Month Visit Open the PDF Link PDF for Bright Futures Parent Handout: 9 Month Visit in another window
• Hojas informativas de Bright Futures para los padres: Visita médica del 9 mes Open the PDF Link PDF for Hojas informativas de Bright Futures para los padres: Visita médica del 9 mes in another window
• Bright Futures Previsit Questionnaire: 12 Month Visit Open the PDF Link PDF for Bright Futures Previsit Questionnaire: 12 Month Visit in another window
• Cuestionario previo a la visita de Bright Futures: Visita médica de 12 mes Open the PDF Link PDF for Cuestionario previo a la visita de Bright Futures: Visita médica de 12 mes in another window
• Bright Futures Visit Documentation Form: 12 Month Visit Open the PDF Link PDF for Bright Futures Visit Documentation Form: 12 Month Visit in another window
• Bright Futures Parent Handout: 12 Month Visit Open the PDF Link PDF for Bright Futures Parent Handout: 12 Month Visit in another window
• Hojas informativas de Bright Futures para los padres: Visita médica del 12 mes Open the PDF Link PDF for Hojas informativas de Bright Futures para los padres: Visita médica del 12 mes in another window
• Bright Futures Previsit Questionnaire: 15 Month Visit Open the PDF Link PDF for Bright Futures Previsit Questionnaire: 15 Month Visit in another window
• Cuestionario previo a la visita de Bright Futures: Visita médica de 15 mes Open the PDF Link PDF for Cuestionario previo a la visita de Bright Futures: Visita médica de 15 mes in another window
• Bright Futures Visit Documentation Form: 15 Month Visit Open the PDF Link PDF for Bright Futures Visit Documentation Form: 15 Month Visit in another window
• Bright Futures Parent Handout: 15 Month Visit Open the PDF Link PDF for Bright Futures Parent Handout: 15 Month Visit in another window
• Hojas informativas de Bright Futures para los padres: Visita médica del 15 mes Open the PDF Link PDF for Hojas informativas de Bright Futures para los padres: Visita médica del 15 mes in another window
• Bright Futures Previsit Questionnaire: 18 Month Visit Open the PDF Link PDF for Bright Futures Previsit Questionnaire: 18 Month Visit in another window
• Cuestionario previo a la visita de Bright Futures: Visita médica de 18 mes Open the PDF Link PDF for Cuestionario previo a la visita de Bright Futures: Visita médica de 18 mes in another window
• Bright Futures Visit Documentation Form: 18 Month Visit Open the PDF Link PDF for Bright Futures Visit Documentation Form: 18 Month Visit in another window
• Bright Futures Parent Handout: 18 Month Visit Open the PDF Link PDF for Bright Futures Parent Handout: 18 Month Visit in another window
• Hojas informativas de Bright Futures para los padres: Visita médica del 18 mes Open the PDF Link PDF for Hojas informativas de Bright Futures para los padres: Visita médica del 18 mes in another window
• Bright Futures Previsit Questionnaire: 2 Year Visit Open the PDF Link PDF for Bright Futures Previsit Questionnaire: 2 Year Visit in another window
• Cuestionario previo a la visita de Bright Futures: Visita médica del 2 año Open the PDF Link PDF for Cuestionario previo a la visita de Bright Futures: Visita médica del 2 año in another window
• Bright Futures Visit Documentation Form: 2 Year Visit Open the PDF Link PDF for Bright Futures Visit Documentation Form: 2 Year Visit in another window
• Bright Futures Parent Handout: 2 Year Visit Open the PDF Link PDF for Bright Futures Parent Handout: 2 Year Visit in another window
• Hojas informativas de Bright Futures para los padres: Visita médica del 2 año Open the PDF Link PDF for Hojas informativas de Bright Futures para los padres: Visita médica del 2 año in another window
• Bright Futures Previsit Questionnaire: 2½ Year Visit Open the PDF Link PDF for Bright Futures Previsit Questionnaire: 2½ Year Visit in another window
• Cuestionario previo a la visita de Bright Futures: Visita médica del 2½ año Open the PDF Link PDF for Cuestionario previo a la visita de Bright Futures: Visita médica del 2½ año in another window
• Bright Futures Visit Documentation Form: 2½ Year Visit Open the PDF Link PDF for Bright Futures Visit Documentation Form: 2½ Year Visit in another window
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KENNETH W. LIN, MD, MPH, Georgetown University School of Medicine, Washington, District of Columbia

Am Fam Physician. 2015;91(6):362-364

More than two-thirds of practicing family physicians report that they provide care for children, 1 and well-child visits provide the best opportunities to deliver evidence-based preventive services. These services include administering immunizations, assessing growth and development, and counseling children and parents about behavioral issues, nutrition, exercise, and prevention of unintentional injury. 2

The American Academy of Pediatrics (AAP) recently updated its recommendations on preventive health care for children, 3 which define a set of services that, under the Affordable Care Act, must be covered by Medicaid and private insurers at no out-of-pocket cost. 4 The current AAP Bright Futures guideline (available at http://www.aap.org/en-us/professional-resources/practice-support/Periodicity/Periodicity%20Schedule_FINAL.pdf ) includes three screening tests that were not recommended for all children in previous versions: autism screening at 18 and 24 months of age, cholesterol screening between nine and 11 years of age, and annual screening for high blood pressure beginning at three years of age.

It should be noted that none of these screening tests are included in the American Academy of Family Physicians' (AAFP's) list of recommended preventive services for children ( Table 1 ) . 5 The AAFP's clinical preventive services recommendations are generally consistent with those of the U.S. Preventive Services Task Force (USPSTF). The USPSTF methods for developing recommendations include performing a systematic evidence review of the benefits and harms of a preventive service, and recommending that the service be provided to the general population only after consistent data from high-quality randomized controlled trials or other prospective studies establish that the benefits exceed the harms. 6 This rigorous approach to the development of clinical practice guidelines has been endorsed by the Institute of Medicine. 7 In contrast, few AAP policy statements on well-child care are supported by direct evidence of net health benefit. 8 , 9

The rationale for the AAP's recommendation to routinely screen toddlers for autism spectrum disorders (ASDs) with ASD-specific screening tools is to advance the time of diagnosis and deliver early interventions. 10 Although a systematic review of 40 studies found that a policy of universal screening for ASD increased rates of diagnosis and referral, the effects of such policies on time of diagnosis or enrollment in services are unclear. 11 The entire body of evidence that intensive behavioral interventions improve language skills and cognitive or functional outcomes in children with ASD consists of a single randomized controlled trial and several prospective cohort studies of varying quality. 12 , 13

The AAP recommends measurement of blood pressure and cholesterol levels in children to identify modifiable risk factors for cardiovascular disease and to provide early interventions to reduce future risk. However, no studies have evaluated whether treating primary hypertension in persons younger than 18 years reduces adverse cardiovascular outcomes in adulthood. 14 , 15 Similarly, evidence is lacking that lowering cholesterol levels with lifestyle changes or medications improves cardiovascular outcomes, and long-term statin use is associated with rare but serious harms. 16 , 17

Time is a precious clinical resource. Clinicians who spend time delivering unproven or ineffective interventions at health maintenance visits risk “crowding out” effective services. For example, a national survey of family and internal medicine physicians regarding adult well-male examination practices found that physicians spent an average of five minutes discussing prostate-specific antigen screening (a service that the AAFP and the USPSTF recommend against because the harms outweigh the benefits 18 ), but one minute or less each on nutrition and smoking cessation counseling. 19 Similarly, family physicians have limited time at well-child visits and therefore should prioritize preventive services that have strong evidence of net benefit.

editor's note: Dr. Lin is associate deputy editor of AFP Online and chair of the Subcommittee on Clinical Practice Guidelines of the AAFP's Commission on the Health of the Public and Science. Because of Dr. Lin's dual roles, two other medical editors independently reviewed this editorial for publication.

Bazemore AW, Makaroff LA, Puffer JC, et al. Declining numbers of family physicians are caring for children. J Am Board Fam Med. 2012;25(2):139-140.

Riley M, Locke AB, Skye EP. Health maintenance in school-aged children: part II. Counseling recommendations. Am Fam Physician. 2011;83(6):689-694.

Simon GR, Baker C, Barden GA, et al. 2014 recommendations for pediatric preventive health care. Pediatrics. 2014;133(3):568-570.

American Academy of Pediatrics. Bright Futures. http://brightfutures.aap.org . Accessed August 20, 2014.

American Academy of Family Physicians. Summary of recommendations for clinical preventive services. July 2014. https://www.aafp.org/dam/AAFP/documents/patient_care/clinical_recommendations/cps-recommendations.pdf . Accessed August 20, 2014.

Melnyk BM, Grossman DC, Chou R, et al. USPSTF perspective on evidence-based preventive recommendations for children. Pediatrics. 2012;130(2):e399-e407.

Graham R, Mancher M, Wolman DM, et al., eds. Clinical Practice Guidelines We Can Trust . Washington, DC: The National Academies Press; 2011.

Moyer VA, Butler M. Gaps in the evidence for well-child care: a challenge to our profession. Pediatrics. 2004;114(6):1511-1521.

Belamarich PF, Gandica R, Stein RE, Racine AD. Drowning in a sea of advice: pediatricians and American Academy of Pediatrics policy statements. Pediatrics. 2006;118(4):e964-e978.

Johnson CP, Myers SM American Academy of Pediatrics Council on Children with Disabilities. Identification and evaluation of children with autism spectrum disorders. Pediatrics. 2007;120(5):1183-1215.

Daniels AM, Halladay AK, Shih A, et al. Approaches to enhancing the early detection of autism spectrum disorders. J Am Acad Child Adolesc Psychiatry. 2014;53(2):141-152.

Warren Z, McPheeters ML, Sathe N, et al. A systematic review of early intensive intervention for autism spectrum disorders. Pediatrics. 2011;127(5):e1303-e1311.

Reichow B, Barton EE, Boyd BA, Hume K. Early intensive behavioral intervention (EBI) for young children with autism spectrum disorders (ASD). Cochrane Database Syst Rev. 2012;10:CD009260.

Chiolero A, Bovet P, Paradis G. Screening for elevated blood pressure in children and adolescents: a critical appraisal. JAMA Pediatr. 2013;167(3):266-273.

Thompson M, Dana T, Bougatsos C, Blazina I, Norris SL. Screening for hypertension in children and adolescents to prevent cardiovascular disease. Pediatrics. 2013;131(3):490-525.

Grossman DC, Moyer VA, Melnyk BM, Chou R, DeWitt TG U.S. Preventive Services Task Force. The anatomy of a U.S. Preventive Services Task Force recommendation: lipid screening for children and adolescents. Arch Pediatr Adolesc Med. 2011;165(3):205-210.

Psaty BM, Rivara FP. Universal screening and drug treatment of dyslipidemia in children and adolescents. JAMA. 2012;307(3):257-258.

Moyer VA U.S. Preventive Services Task Force. Screening for prostate cancer: U.S. Preventive Service Task Force recommendation statement. Ann Intern Med. 2012;157(2):120-134.

Pollack KI, Krause KM, Yarnall KS, Gradison M, Michener JL, Østbye T. Estimated time spent on preventive services by primary care physicians. BMC Health Serv Res. 2008;8:245.

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Catch Up on Well-Child Visits and Recommended Vaccinations

Many children missed check-ups and recommended childhood vaccinations over the past few years. CDC and the American Academy of Pediatrics (AAP) recommend children catch up on routine childhood vaccinations and get back on track for school, childcare, and beyond.

Making sure that your child sees their doctor for well-child visits and recommended vaccines is one of the best things you can do to protect your child and community from serious diseases that are easily spread.

Well-Child Visits and Recommended Vaccinations Are Essential

Well-child visits and recommended vaccinations are essential and help make sure children stay healthy. Children who are not protected by vaccines are more likely to get diseases like measles and whooping cough . These diseases are extremely contagious and can be very serious, especially for babies and young children. In recent years, there have been outbreaks of these diseases, especially in communities with low vaccination rates.

Well-child visits are essential for many reasons , including:

• Tracking growth and developmental milestones
• Discussing any concerns about your child’s health
• Getting scheduled vaccinations to prevent illnesses like measles and whooping cough (pertussis) and  other serious diseases

It’s particularly important for parents to work with their child’s doctor or nurse to make sure they get caught up on missed well-child visits and recommended vaccines.

Routinely Recommended Vaccines for Children and Adolescents

Getting children and adolescents caught up with recommended vaccinations is the best way to protect them from a variety of   vaccine-preventable diseases . The schedules below outline the vaccines recommended for each age group.

See which vaccines your child needs from birth through age 6 in this easy-to-read immunization schedule.

See which vaccines your child needs from ages 7 through 18 in this easy-to-read immunization schedule.

The  Vaccines for Children  (VFC) program provides vaccines to eligible children at no cost. This program provides free vaccines to children who are Medicaid-eligible, uninsured, underinsured, or American Indian/Alaska Native. Check out the  program’s requirements  and talk to your child’s doctor or nurse to see if they are a VFC provider. You can also find a VFC provider by calling your  state or local health department  or seeing if your state has a VFC website.

COVID-19 Vaccines for Children and Teens

Everyone aged 6 months and older can get an updated COVID-19 vaccine to help protect against severe illness, hospitalization and death. Learn more about making sure your child stays up to date with their COVID-19 vaccines .

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The Well-Visit Planner for Families

The Well-Visit Planner is an Internet-based tool (www.wellvisitplanner.org) developed to improve well-child care for children 4 months to 6 years of age. Information in this tool is based on recommendations established by the American Academy of Pediatrics Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, 3rd Edition . The tool helps parents and caregivers to customize the well-child visit to their family's needs by helping them identify and prioritize their health risks and concerns before the well-child appointment. This means that parents and health care professionals are better able to communicate and address the family's needs during the well-child visit.

The Well-Visit Planner and Head Start

The Child and Adolescent Health Measurement Initiative (CAHMI) has worked with the Office of Head Start National Center on Health to expand the Well-Visit Planner through age 6 years and has prepared materials to help Head Start and Early Head Start programs use this tool with the families they serve. Knowing that school readiness begins with health, Head Start and Early Head Start programs are committed to supporting the health and well-being of every child enrolled in a program. The Well-Visit Planner has been tested in several programs, and staff have found it helpful for encouraging parents to complete well-child visits and become familiar with what is expected at each visit. The tool also reinforces the role of parents as the experts for their child's needs—including those related to health.

Using the Well-Visit Planner in Head Start and Early Head Start Programs

In partnership with the National Center on Health, CAHMI has prepared a number of tools and resources to help programs assess their readiness to begin using the Well-Visit Planner as a standard part of their work with parents and children. There is also an implementation toolkit that helps programs with step-by-step implementation of the Well-Visit Planner within the program, including materials to help promote the use of the tool among parents. Materials are also there to help reach out to local health care professionals to help prepare them for the use of the Well-Visit Planner by their patient families.

These materials will be housed on the Early Childhood Learning & Knowledge Center but are currently available at http://www.cahmi.org/projects/wvp/ , the implementation-portal.

How does the Well-Visit Planner help families?

Completing the tool, which takes about 15 to 20 minutes, will help empower parents and caregivers to identify priorities for a child's upcoming well-child visit; it will also prepare them for what to expect at that visit. The content of the Well-Visit Planner is different based on the age of the child. It is developed to be used before each well-child visit through 6 years of age. The Well-Visit Planner also includes educational materials about topics such as a child's growth and development, language development, and safety. The educational materials address the topics of most importance for each age.

After parents use the Well-Visit Planner, they can save or print a summary or Visit Guide of the needs and priorities for the visit. They will take this summary with them to help prioritize their time with the child's pediatrician or primary health care professional. Parents can print a copy to leave with the physician or send a copy prior to the visit if the child's physician has a secure email address. The summary can also be discussed with the parents, and the family service worker and integrated into the family partnership agreement.

The Well-Visit Planner for Families The Well Visit Planner online tool: http://wellvisitplanner.org/

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National Centers: Health, Behavioral Health, and Safety

Audience: Families

Last Updated: November 21, 2023

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If your child has asthma, and is coming for an asthma-related visit, or for a routine well-care checkup, please complete one of the following forms:.

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Well-Child Care

Improving infant well-child visits.

High-quality well-child visits can improve children’s health, support caregivers’ behaviors to promote their children’s health, and prevent injury and harm. The American Academy of Pediatrics and Bright Futures recommend nine well-care visits by the time children turn 15 months of age. These visits should include a family-centered health history, physical examination, immunizations, vision and hearing screening, developmental and behavioral assessment, an oral health risk assessment, a social assessment, maternal depression screening, parenting education on a wide range of topics, and care coordination as needed. i  When children receive the recommended number of high-quality visits, they are more likely to be up-to-date on immunizations, have developmental concerns recognized early, and are less likely to visit the emergency department. ii , iii , iv , v , vi , vii  However, many infants do not receive the recommended number of infant well-child visits. 

The Centers for Medicare & Medicaid Services (CMS) offers quality improvement (QI) technical assistance (TA) to help states increase the attendance and quality of well-child visits for Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries ages 0 to 15 months.

QI TA resources , to help state Medicaid and CHIP staff and their QI partners get started improving the use of infant well-child visits for their beneficiaries

Improving Infant Well-Child Visit learning collaborative resources , to share different approaches to improving well-child visit care and state examples

For more information on these materials and other QI TA, please email [email protected] .

QI TA Resources

These resources can help states get started in developing their own infant well-child QI projects:

Getting Started on Quality Improvement Video . This video provides an overview of how Medicaid and CHIP agencies can start a QI project to improve the use of infant well-child visits. The Model for Improvement begins with small tests of change, enabling state teams to “learn their way” toward strong programs and policies.

Driver Diagram and Change Idea Table . A driver diagram is a visual display of what “drives” or contributes to improvements in infant well-child visits. This example of a driver diagram shows the relationship between the primary drivers (the high-level elements, processes, structures, or norms in the system that must change to use and quality of infant well-child visits) and the secondary drivers (the places, steps in a process, time-bound moments, or norms in which changes are made to spur improvement). The document also includes change idea tables, which contain examples of evidence-based or evidence-informed QI interventions to improve the use of infant well-child care. The change ideas were tailored for Medicaid and CHIP.

Measurement Strategy . This document provides examples of measures that can be used to monitor infant well-child care QI projects.

Improving Infant Well-Child Visits: Learning Collaborative Resources

Beginning in 2021, CMS facilitated the two year Infant Well-Child Visit learning collaborative to support state Medicaid and CHIP agencies’ efforts to improve the use of infant well-child visits from 0-15 months of age. The learning collaborative included a webinar series and an affinity group to support state Medicaid and agencies’ quality improvement efforts. The webinars, listed and linked to below, described approaches that states can use to improve attendance and quality of infant well-child visits.

California, Missouri, North Carolina, South Carolina, Texas and Virginia participated in the action-oriented affinity group where teams designed and implemented an infant well-child quality improvement (QI) project in their state with tailored TA from CMS. Learnings from participating states can be found in the state highlights brief.

Learning Collaborative Webinar Series

State Spotlights Webinar on Improving Infant-Well Child Care ( Video ) ( Transcript ). This 2024 webinar spotlighted several state QI projects from the affinity group, highlighting their strategies, partnerships, and lessons learned.

Using Payment, Policy and Partnerships to Improve Infant Well-Child Care ( Audio )( Transcript ). This August 2021 webinar focused on Medicaid and CHIP payment incentives, managed care contracts, and other strategies that can increase the use and quality of infant well-child visits and advance equity. Speakers from the CMS and Mathematica introduced CMS’ Maternal and Infant Health Initiative and shared the importance of high-quality well-child visits and the opportunities within Medicaid and CHIP to impact infant health. Speakers from Pennsylvania and Texas’ Medicaid and CHIP agencies described their efforts to expand and incentivize participation in infant well-child visits, such as through value-based purchasing, performance improvement projects, CHIP Health Services Initiatives (HSIs), and partnerships with aligned service providers like the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). State presenters offered insights into ways to incentivize efforts to close gaps in care, engage families, and improve performance on quality measures. During the Q&A session, presenters discussed the impact of the COVID-19 pandemic on well-child care, the potential of using telehealth or hybrid visits to increase access, and incentives for managed care entities, and addressing the social determinants of health in value-based payment strategies.

  Improving Quality and Utilization of Infant Well-Child Visits ( Audio )( Transcript ). This September 2021 webinar focused on the characteristics of a high-performing system of well-child health care. CMS and Mathematica presenters shared the Maternal and Infant Health Initiative’s Theory of Change. Speakers from Washington and Arkansas Medicaid and CHIP agencies discussed how their states have achieved high rates of participation in infant well-child visits and how they use data to monitor performance and disparities and ensure access to services. Washington shared insights on leveraging collaborative performance improvement projects to identify and address barriers to care. Arkansas discussed the state’s per member per month incentives for performance and minimum performance measures for infant well-child visit rates. During the Q&A session, presenters highlighted efforts to improve health equity, engage parents and providers, and leverage performance measures and quality tools to improve attendance at infant well-child visits.

Models of Care that Drive Improvement in Infant Well-Child Visits ( Audio )( Transcript ). In this September 2021 webinar, three states—Oregon, Michigan, and North Carolina—shared approaches to designing and implementing models of care associated with improved infant well-child visit participation, including patient-centered medical homes (PCMHs) and home visiting. States offered insights on the importance of strategic alignment of policies, processes, and partnerships. Oregon discussed its home visiting program and quality incentive strategy for its coordinated care organizations. The state incentivizes progress on the HEDIS measures and other measures designed by the state’s Pediatric Improvement Partnership, including a measure of social-emotional health service capacity and access for infants and children. Michigan discussed how they requires MCOs to identify and publish disparities in well-child visit rates and how they encourage plans to reduce disparities. The state also uses an algorithm that automatically assigns members to MCOs based on MCOs’ performance and reimburses for maternal-infant health home visiting. North Carolina shared its Keeping Kids Well program, which aims to increase well-child visit and immunization rates and reduce disparities in those rates. The program offers coaches to practices to support their improvements, established an advisory board of key interested parties, and provides customized vaccination notices for practices to distribute to beneficiaries, in partnership with health systems and pharmaceutical companies. The state also used the Healthy Opportunities payment to incentivize the identification and redress of health-related social needs and provided the Health Equity Payment to providers serving areas with high poverty rates. 

i 3 Hagan, J.F., J.S. Shaw, and P.M. Duncan (eds.). Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents. 4th ed. Elk Grove Village, IL: American Academy of Pediatrics, 2017.

ii Gill, J.M., A. Saldarriaga, A.G. Mainous, and D. Unger. “Does Continuity Between Prenatal and Well-Child Care Improve Childhood Immunizations?” Family Medicine, vol. 34, no. 4, April 2002, pp. 274–280.

iii Buchholz, M., and A. Talmi. “What We Talked About at the Pediatrician’s Office: Exploring Differences Between Healthy Steps and Traditional Pediatric Primary Care Visits.” Infant Mental Health Journal, vol. 33, no. 4, 2012, pp. 430–436.

iv DeVoe, J.E., M. Hoopes, C.A. Nelson, et al. “Electronic Health Record Tools to Assist with Children’s Insurance Coverage: A Mixed Methods Study.” BMC Health Services Research, vol.18, no. 1, May 2018, p. 354–360.

v Coker, T.R., S. Chacon, M.N. Elliott, et al. “A Parent Coach Model for Well-Child Care Among Low-Income Children: A Randomized Controlled Trial.” Pediatrics, vol. 137, no. 3, March 2016, p. e20153013.

vi Flores, G., H. Lin, C. Walker, M. Lee, J. Currie, R. Allgeyer, M. Fierro, M. Henry, A. Portillo, and K. Massey. “Parent Mentoring Program Increases Coverage Rates for Uninsured Latino Children.” Health Affairs, vol. 37, no. 3, 2018, pp. 403–412.

vii Hakim, R.B., and D.S. Ronsaville. “Effect of Compliance with Health Supervision Guidelines Among US Infants on Emergency Department Visits.” Archives of Pediatrics & Adolescent Medicine, vol. 156, no. 10, October 2002, pp. 1015–1020.

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Well-child visits and immunization.

Well-child visits and recommended immunizations are essential and help make sure children stay healthy. Many children and adolescents have missed these important checkups during the pandemic.

Keep your kids on track: Schedule a well-child visit now

Well-child visits are regular checkups that should be free or low-cost. These visits are important for tracking your child's growth and developmental milestones, discussing any concerns about your child's health, and getting recommended vaccinations, including COVID-19 vaccine, to prevent illnesses. Call your child's health care provider to schedule a visit today.

Looking for a health care provider or clinic for your child?

For children covered by Medical Assistance (MA), these visits, called Child and Teen Checkups (C&TC), are free for newborns through age 20 years. If you do not have a health care provider or clinic, your county or tribal C&TC coordinator can help. Find contact information for your local C&TC staff statewide at Free Child and Teen Checkups (developed by Hennepin County C&TC) by scrolling down to the "Need help with your appointment?" section and use the drop-down box to select your county or tribal affiliation. If you do not have internet access or need help connecting to your local C&TC coordinator, please call the state's C&TC program at 651-431-3429.

For children covered by other health insurance, contact member services to find a clinic near you where the well-child visit may be paid for by your health insurance.

Looking for health insurance?

To find health coverage options for you and your family, visit: MNSure or call: 651-539-2099 or 855-366-7873.

Resources for health care providers

Key talking points to communicate with families about the importance of well-child visits and vaccines:

• Healthy children are more likely to grow up to be healthy adults. Regular checkups, called well-child visits, give parents and health care providers an opportunity to check children's growth and development, identify any concerns, and treat them early to prevent bigger problems later on.
• Many children have missed these important checkups where they get routine immunizations, putting them and the community at risk for certain disease outbreaks.
• Keep your kids on track with the recommended immunization schedule developed to protect infants and children by providing immunity early in life before they are exposed to potentially life-threatening diseases. It’s never too late to get your kids caught-up on the vaccines they need to stay healthy.

Give the following handout to families to promote well-child visits and getting kids back on track with recommended vaccines.

Keep Your Kids on Track

Keep Your Kids On Track: Schedule a well-child visit now (PDF) Half sheet handout, two per page.

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• Catch Up on Well-Child Visits and Recommended Vaccinations Visit CDC for more resources to promote catch-up on well-child visits and recommended vaccines.

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Foster Care Forms

• DHS-904 Foster Care/Adoption/Juvenile Justice Caseworker/Child Visit - Quick Reference Guide Rev 01/20
• DHS-904-A Foster Care/Adoption/Juvenile Justice Caseworker/Child Visit Tool Rev 01/20
• DHS-0665 CFC Permanent Ward Court Report Rev 04/12
• DHS-1280 CFC Initial Court Report Rev 05/12
• DHS-1281 CFC Updated Court Report Rev 07/12
• MDHHS-5964 Court Cover Letter Rev 07/21
• Identity Theft Tip Sheet
• DHS-762, Annual Credit Report Request
• DHS-470-A, Assessment for Determination of Care for Children in Foster Care Ages 13+ Rev 06/23a
• DHS-470 Assessment for Determination of Care for Children in Foster Care Ages 0-12 Rev 06/23
• DHS-668 Administrative Review Request for Determination of Care Denial Rev 11/19
• DHS-1254, SED Waiver Foster Home Payment Request and Approval Rev 03/24
• DHS-1945 Assessment for Determination of Care (DOC) for Medically Fragile Children in Foster Care Rev 05/23
• DHS-1104, Family Team Meeting Rev 05/15
• Family Team Meeting Protocol Rev 04/13
• DHS-1104, Family Team Meeting Protocol - Spanish Rev 05/15
• DHS-1105, Family Team Meeting Report Rev 09/18
• DHS-1105-SP, Family Team Meeting Activity Report - Spanish Rev 06/17
• DHS-1107, A Caseworker's Guide to Pre-Meeting Discussions and Family Team Meetings Rev. 03-16
• DHS-1109, Family Team Meeting Invite Rev 09/11
• MDHHS-PUB-1160, A Family's Guide to Pre-Meeting Discussions and Family Team Meetings Rev 11/15
• Waiver of Foster Care Payments in Lieu of Government Benefits Rev 04/22
• DHS-30 Foster Parent/Caregiver Notice of Move Rev 01/22
• DHS-31 Foster Care Placement Decision Notice Rev 07/21
• DHS-57 Foster Care Transitional Medicaid Rev 9/15
• DHS-67A Treatment Foster Care Parent-Agency Treatment Plan and Service Agreement Rev. 10/17
• DHS-197 - Home Study Outline Rev 05/15v
• DHS-221, Medical Passport Rev 02/13
• DHS-348, Michigan Works! Workforce Innovation and Opportunity Act Agency Referral Rev 04/18
• DHS-396 Residential Placement Exception Request Rev 7/12
• DHS-589 Recoupment Notice Rev 06/14
• DHS-594 Parental Placement of MCI Ward Request Rev. 04-19
• DHS-602 Adoption Referral Rev 11/11
• DHS-637 Caseworker Visit Report Rev 8/08
• DHS-649 Foster Care/Juvenile Justice Child Fatality Notification Rev 06/15
• DHS-659, Foster Care Payment Authorization Rev 09/19
• DHS-659-CCI Foster Care Payment Authorization CCI Rev 09/19
• MDHHS-710 Clearance to Publish Information on AWOLP Youth Rev 09/23
• DHS-715 Hearing Notice Rev 06/21
• DHS-715 Hearing Notice (Spanish) Rev 06/21
• DHS-715 Hearing Notice (Arabic) Rev 06/21
• DHS-719-CWFS, Child Welfare Funding Specialist Tool Rev 02/17
• DHS-786 Independent Living Plus Extension Request Rev 1/14
• DHS-790, Foster Parent Orientation Video Questions Rev 07/11
• DHS-867 - Notification to Court of Jurisdiction and Child's Lawyer Guardian Ad Litem Rev 05/15
• DHS-901-A, Semi-Annual Transition Plan Report, Youth Age 14-15 Rev 09/23
• DHS-901-B, Semi-Annual Transition Plan Report, Youth Age 16 and Older Rev 09/23
• DHS-902, 90-Day Discharge Plan Report Rev 02/19
• School Notification and Education Records Release - DHS-942 Rev 07/22
• DHS-945, Financial Aid Verification of Court/State Ward Status
• DHS-956, Youth Housing Referral Rev 10/18
• DHS-1445, Child Support Confidential Locate Request Rev 11/19
• DHS-1476 Early Discharge of MCI Ward Rev 05/17
• DHS-1555-CS, Authorization to Release Confidential Information Rev 05/17
• DHS-2351-X, Bridges Provider Enrollment/Change Request Rev 07/18
• DHS-3198, Unauthorized Leave Notification Rev 05/15
• DHS 3198-A Unauthorized Leave Report to Court/Law Enforcement Rev 10/23
• DHS-3307 Placement Outline and Information Record Rev 05/21
• DHS-3377 Clothing Inventory Checklist Rev 8/19
• DHS-4527, Independent Living Agreement Rev 9/17
• DHS-5307 Rights And Responsibilities For Children and Youth In Foster Care Rev 05/19
• DHS-5307-SP Rights And Responsibilities For Children and Youth In Foster Care Rev 5/19
• DHS-5307-AR Rights And Responsibilities For Children and Youth In Foster Care Rev 5/19
• DHS-5331 Guidelines for Reasonable and Prudent Parent Standard Rev. 02/17
• DHS-5333 Conversation Guide on Return from AWOLP Rev. 9/15
• MDHHS-5406 - Bed Hold Payment Request Rev 09/19
• MDHHS-5406-IL, Bed Hold Payment Request for Independent Living Placements Rev 01/21
• MDHHS-5523, Human Trafficking Screening Tool - Ongoing Cases Rev 06/17
• MDHHS-5524, Human Trafficking Screening Tool - Closed Cases Rev 06/17
• MDHHS-5594, Trauma Assessment Referral Rev. 03/24
• MDHHS-5599, Ancillary Service Approval Rev. 12/23
• MDHHS-5748, Verification of Placement in Foster Care Rev 07/18
• MDHHS-5822, Pre-Approval Request for Foster Parent Mileage Reimbursement for Visitation Travel Over 150 Miles Round Trip Rev 02/22
• MDHHS-5829, Family Incentive Grant (FIG) and Unlicensed Relative Caregiver Funding Rev 08/20
• MDHHS-5841, Waiver of Foster Care Payments in Lieu of Government Benefits Rev 11/23
• MDHHS-5841-A, Waiver of Foster Care Payments in Lieu of Government Benefits Rev 03/23
• MDHHS-5853, GROW Training Referral Rev 10/23
• MDHHS-5855, Orthodontic Payment Agreement Rev 07/22
• MDHHS-5902 Caregiver Support and Resource Plan Rev 10/23
• Residential Referral Checklist - MDHHS-5928 Rev 04/22
• MDHHS-5967, Overpayment Notification Rev 07/21
• MDHHS-6070, Unlicensed Respite Provider Clearances Rev 10-23
• MDHHS-6071, Respite Services Exception Rev 10-23
• MDHHS-6072, Respite Child Information and Case Plan Rev 10-23
• For Forms Required for Interstate Compact, go to Interstate Compact Forms
• DHS-599, Foster Care Supportive Visitation and In-Home Parent Education Referral Rev 10/23
• DHS-1469, Foster Care Supportive Visitation and In-Home Parent Education Visit Report Rev 10/15
• DHS-1470, Foster Care Supportive Visitation Termination Report Rev 02/19
• DHS-1471, Foster Care Supportive Visitation and In-Home Parent Education Initial Assessment Rev 02/19
• DHS-1472, Foster Care Supportive Visitation Service Agreement Rev 010/20
• DHS-1473, Foster Care Supportive Visitation and In-Home Parent Education Weekly Progress Report Rev 02/18
• DHS-1474 Foster Care Supportive Visitation and In-Home Parent Education Contract Compliance Rev 10/20
• MDHHS-5465, Family Satisfaction Survey Foster Care Supportive Visitation Rev 10/16
• MDHHS-5466, Referring Worker Satisfaction Survey, Foster Care Supportive Visitation Rev 10/20
• MDHHS-5716 - Foster Care Supportive Visitation and In-Home Parent Education Follow-Up Summary/Attempt Rev 10/20
• DHS-347 - Permanency Goal Approval Rev. 09/15
• DHS-569 Permanency Goal Support Agreement Rev. 08/15
• DHS-643 - Permanency Goal Review Rev. 08/15
• DHS-541 Relative Licensing Referral Agreement Rev 04/19
• DHS-987, Relative Documentation Rev. 05/15
• DHS-987-SP Relative Documentation Rev 05/15
• DHS-990 Relative Notification Letter Rev 03/21
• DHS-990-SP, Relative Notification Letter (Spanish) Rev 03/21
• DHS-990-AR Relative Notification Letter (Arabic) Rev 03/21
• MDHHS-991 Diligent Search Checklist Rev 05/16v
• Relative Caregiving: What You Need to Know DHS-Pub-114 Rev 01/16
• MDHHS-5770, Relative Placement Safety Screen Rev 09/21
• DHS-145 Family Assessment of Needs & Strengths Rev. 10/15
• DHS-365-A Children's Foster Care Residential Initial Service Plan (10-13 yrs) Rev. 01/16
• DHS-365 Children's Foster Care Residential ISP (4-9 yrs) Rev. 12/15
• DHS-365-B Children's Foster Care Residential Initial Service Plan (14 yrs and older) Rev. 01/16
• DHS-366-A Children's Foster Care Residential Updated Service Plan (10-13 yrs) Rev. 12/15
• DHS-366-B Children's Foster Care Residential Updated Service Plan (14 yrs and older) Rev. 02/16
• DHS-366 Children's Foster Care Residential Updated Service Plan (4-9 yrs) Rev. 12/15
• DHS-5335 Juvenile Justice Service Plan Addendum Rev. 02/16
• MDHHS-5931, Residential Aftercare Report Rev. 06/21
• MDHHS-5985, Incident Report Rev. 12/21
• MDHHS-5999, Residential Foster Care Abuse Neglect (RFCAN) and Residential Foster Care Juvenile Justice (RFCJJ) Contract - Qualified Residential Treatment Program (QRTP) Re-Certification Rev. 04/23
• DHS-449 Juvenile Justice Reentry Care Coordination Referral Rev. 01/20
• MDHHS-Pub-1243-AR, Preventing Sexual Assault - Youth Orientation Packet (Arabic) Rev. 04/19
• MDHHS-Pub-1243, Preventing Sexual Assault - Youth Orientation Packet Rev. 04/19
• MDHHS-Pub-1243-SP, Preventing Sexual Assault - Youth Orientation Packet (Spanish) Rev. 04/19
• MDHHS-5520 Residential AWOLP and Escape Checklist Rev. 03/18
• MDHHS-5605, Juvenile Justice Residential Youth Orientation Checklist Rev. 11/17
• MDHHS-5606, Prison Rape Elimination Act (PREA) Screening Tool Rev. 03/24
• MDHHS-5606-AR, Prison Rape Elimination Act (PREA) Screening Tool (Arabic) Rev. 03/24
• MDHHS-5606-SP, Prison Rape Elimination Act (PREA) Screening Tool (Spanish) Rev. 03/24
• MDHHS-5799-PREA, PREA Retaliation Monitoring Log Rev. 05/19
• MDHHS-5809-PREA, Prison Rape Elimination Act (PREA) Investigation Tool Rev. 08/19
• MDHHS-5810-PREA, Prison Rape Elimination Act (PREA) Investigation Report Rev. 03/21
• MDHHS-5817-PREA, Annual Prison Rape Elimination Act (PREA) Staffing Plan Review Rev. 08/19
• MDHHS-5818-PREA, 30-Day Sexual Abuse Incident Review Rev. 08/19
• MDHHS-5830-PREA, Prison Rape Elimination Act (PREA) Unannounced Rounds Log Rev. 11/19
• MDHHS-5833-PREA, Prison Rape Elimination Act (PREA) Staffing Plan Rev. 10/20
• MDHHS-5999, Residential Foster Care Abuse Neglect (RFCAN) and Residential Foster Care Juvenile Justice (RFCJJ) Contract - Qualified Residential Treatment Program (QRTP) Re-Certification Rev. 05/22
• DHS-235, Juvenile Justice Community Based Support Plan
• MDHHS-5680, Juvenile Justice Community Based Termination Report
• MDHHS-5687, Juvenile Justice Diversion and Reintegration Alternative Services Referral Information
• MDHHS-5689, Case Notes
• Search for a Court Form
• DHS-69 Foster Care/Juvenile Justice Action Summary Rev. 04/22
• DHS-1154 Foster Care Supervisory Guide Rev 04/13
• DHS-1155 Foster Care Supervisory Tool Rev 07/13
• DHS-65A Treatment Foster Care Initial Service Plan Rev. 10/17
• DHS-66A Treatment Foster Care Updated Service Plan Rev. 10/17
• DHS-68A Treatment Foster Care Permanent Ward Service Plan Rev. 10/17
• DHS-974 Treatment Foster Care Extension Request Rev. 09/09
• DHS-975 Treatment Foster Care Exception Request Rev. 10/09
• DHS-976 Treatment Foster Care Denial of Referral Rev. 04/14
• DHS-977 Treatment Foster Care Referral Acceptance Rev. 12/08
• DHS-978 Treatment Foster Care Placement Request Rev. 05/18
• DHS-979 Treatment Foster Care Discharge Report Rev. 03/09
• DHS-193, Foster Care Transitional Medicaid (FCTMA) Rev. 01/15
• DHS-Pub-268, Guidelines for Foster Parents and Relative Caregivers for Health Care and Behavioral/Mental Health Service Rev. 06/23
• DHS-Pub-268-AR, Guidelines for Foster Parents and Relative Caregivers for Health Care and Behavioral/Mental Health Service (Arabic) Rev. 06/23
• DHS-Pub-268-SP, Guidelines for Foster Parents and Relative Caregivers for Health Care and Behavioral/Mental Health Service (Spanish) Rev. 06/23
• DHS-0439, Notice of Health Care Coverage for Former Foster Youth Extended to Age 26 Rev. 11/15
• DHS-579, Well Child Exam Infancy: 4 Weeks Rev. 04/16
• DHS-580, Well Child Exam Infancy: 1 Week Visit Rev. 06/15
• DHS-581, Well Child Exam Infancy: 4 Months Rev. 06/15
• DHS-0583, Well Child Exam Infancy: 2 Months Rev. 08/11
• DHS-1147 - Foster Care Youth Health Services Refusal Rev. 05/19
• DHS-1556, Behavioral/Mental Health Exception Rev. 08/17
• DHS-1631, Well Child Exam Early Childhood: 18 Months Rev. 06/15
• DHS-1632 Well Child Exam Early Childhood 2 Years Rev. 06/15
• DHS-1633, Well Child Exam Early Childhood: 30 Months Rev. 07/15
• DHS-1634 Well Child Exam Early Childhood 3 Years Rev. 04/16
• DHS-1635 Well Child Exam Early Childhood 5 Years Rev. 06/15
• DHS-0381 Well Child Exam Middle Childhood 6-10 Years Rev. 06/15
• DHS-1636, Well Child Exam Early Adolescence: 11-14 Years Rev. 07/11
• DHS-1637 Well Child Exam Early Adolescence: 15 - 18 Years Rev. 08/15
• DHS-1638, Well Child Exam Early Childhood: 9 Months Rev. 07/11
• DHS-1639, Well Child Exam Early Childhood: 12 Months Rev. 08/11
• DHS-1640, Well Child Exam Early Childhood: 15 Months Rev. 06/15
• DHS-1641, Well Child Exam Infancy: 6 Months Rev. 06/15
• DHS-1642, Well Child Exam Early Childhood: 4 Years Rev. 08/11
• DHS-1643, Psychotropic Medication Informed Consent Rev. 03/21
• DHS-1664, Youth Dental Exam Rev 10/21
• MDHHS-5338, Foster Care Well Child Exam/EPSDT Appointment Verification Rev. 12-15
• DHS-38, Verification of Employment Rev. 12/07
• DHS-54A, Medical Needs Rev. 10/08
• DHS-333, YAVFC Poster Rev. 7/13
• DHS-650-YA, Young Adult Extension Unit Checklist Rev. 09/19
• DHS-1295, Young Adult Monthly Visit Report Rev. 12/18
• DHS-1297, Young Adult Voluntary Foster Care Agreement Rev. 10/22
• DHS-1297-SP, Young Adult Voluntary Foster Care Agreement (Spanish) Rev. 10/22
• DHS-1301-YA, Young Adult Voluntary Foster Care Case Denial/Closure Notice Rev. 08/23
• DHS-1302, Young Adult Voluntary Foster Care Case Closure Request Rev. 05/17
• DHS-3380, Verification of Student Information Rev. 10/12
• MDHHS-5778, Young Adult Voluntary Foster Care Verification of Eligibility Rev. 02/20