California health assessment form 2026

1. Click ‘Get Form’ to open the California Health Assessment Form in our editor.
2. Begin by filling out Section 1, which requires your child's information. Enter their first name, last name, middle initial, birth date, address, city, ZIP code, school name, teacher's name, grade, and sex. 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 important assessments regarding caries experience and treatment urgency. Make sure the dentist marks each box appropriately and signs the form.
4. If you are unable to obtain a dental check-up for your child, complete Section 3. Check the appropriate box that explains why you are requesting an exemption from this requirement and provide your signature and date.
5. Review all sections for completeness before submitting. Once finalized, return the form to your child's school by May 31 of their first school year.

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