Physical form 3 2026

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The document is a Child Health Record form used for screenings and physical examinations of children aged 3-5 years, as required by Head Start and recommended by the American Academy of Pediatrics. It includes sections for relevant health information, screening tests with results, a physical examination assessment, and findings with treatment recommendations.

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Click ‘Get Form’ to open it in the editor.
Begin by entering the child's birthdate, name, sex, Head Start center, phone number, and address in the designated fields.
In the 'Relevant Information' section, summarize health history and observations from parents or teachers.
For 'Screening Tests', fill in the required tests with dates and results. Use 'N', 'S', or 'A' for normal, suspect, or atypical/abnormal results respectively.
Complete the 'Physical Examination/Assessment' section by evaluating each aspect of the child's health. Mark as normal or abnormal and provide comments if necessary.
Finally, document any findings, treatments, and recommendations at the end of the form. Ensure to sign and date where indicated.

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