California health assessment form 2026

1. Click ‘Get Form’ to open the California Health Assessment Form in our editor.
2. Begin with Section 1, where you will enter your child's information. Fill in the child's first name, last name, middle initial, birth date, address, city, ZIP code, school name, teacher's name, grade, sex, and race/ethnicity. Ensure all fields are completed accurately.
3. If your child has had a dental check-up within the last 12 months, Section 2 must be filled out by a licensed dental professional. This section includes marking boxes for visible decay and treatment urgency. Make sure to have the professional sign and date this section.
4. If you are unable to obtain a dental check-up for your child, proceed to Section 3. Here you can request a waiver by checking the appropriate box that describes your situation and providing any additional reasons if necessary. Don’t forget to sign and date this section.
5. Once all sections are completed, review the form for accuracy before submitting it back to your child's school by May 31.

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