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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by entering the child's birthdate, name, sex, Head Start center, phone number, and address in the designated fields.
  3. In the 'Relevant Information' section, summarize health history and observations from parents or teachers.
  4. 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.
  5. 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.
  6. Finally, document any findings, treatments, and recommendations at the end of the form. Ensure to sign and date where indicated.

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