Ct early childhood health forms

• [PDF File]STATE OF CONNECTICUT

  https://info.5y1.org/ct-early-childhood-health-forms_1_4db4ba.html

  o “CT Early Childhood Health Assessment Record” (for children ages birth to 5) or Health Assessment Record ( for school age children) for each household member under 18 years of age.

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• [PDF File]CD 322 - Child Care Staff Health Assessment

  https://info.5y1.org/ct-early-childhood-health-forms_1_0d0b86.html

  CHILD CARE STAFF HEALTH ASSESSMENT (55 Pa. Code §§3270.151, 3280.151 and 3290.151) NAME OF PERSON EXAMINED (Please print) REASON FOR EXAMINATION Initial employment in child care Biennial re-examination THIS SECTION TO BE COMPLETED BY EMPLOYER This physical examination is for the purpose of employment in a child care facility.

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• [PDF File]Connecticut Office of Early Childhood ...

  https://info.5y1.org/ct-early-childhood-health-forms_1_03b3d5.html

  A) Background and Office of Early Childhood Overview . Office of Early Childhood . The Office of Early Childhood (OEC) is the state agency charged with fostering cross-systems integration, coordination, and collaboration at the state and local level in order to enhance the health and well-being of young children, families and communities.

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• State of Connecticut Department of Education Health ...

  Part 3 — Oral Health Assessment/Screening Health Care Provider must complete and sign the oral health assessment. To Parent(s) or Guardian(s): State law requires that each local board of education request that an oral health assessment be conducted prior to public school

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• State of Connecticut Department of Education Early ...

  Early Childhood Health Assessment Record (For children ages birth–5) To Parent or Guardian: In order to provide the best experience, early childhood providers must understand your child’s health needs. This form ... If your child does not have health insurance, call 1-877-CT-HUSKY

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• [PDF File]State of Connecticut Department of Education Early ...

  https://info.5y1.org/ct-early-childhood-health-forms_1_f8d054.html

  Early Childhood Program (Name and Phone Number) Health Insurance Company/Number* or Medicaid/Number* If your child does not have health insurance, call 1-877-CT-HUSKY Address (Street, Town and ZIP code) Parent/Guardian Name (Last, First, Middle) Home Phone Cell Phone Does your child have health insurance? Y N Does your child have dental insurance?

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• [PDF File]Connecticut Early Childhood Health Assessment Record

  https://info.5y1.org/ct-early-childhood-health-forms_1_a28402.html

  Connecticut Early Childhood Health Assessment Record To Parent or Guardian: In order to provide the best experience, early childhood providers must understand your child's health needs. This form requests information from you (Part I) which will also be helpful to the health care provider when he or she completes the health evaluation (Part II).

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• [PDF File]State of Connecticut: Office of Early Childhood Head ...

  https://info.5y1.org/ct-early-childhood-health-forms_1_a604ce.html

  State of Connecticut: Office of Early Childhood Head Teacher Experience Verification Form Use this form to legally verify the experience claimed in your application (see subsequent pages) Mail your documentation to: • CT Early Childhood Professional Registry • 450 Columbus Blvd, Suite 304 • Hartford, CT 06103 OR fax to:

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• Required Immunizations

  determined by the State of Connecticut Department of Public Health. Please see the Early Childhood Health Assessment Record for the current CT Immunization Requirements Schedule for Day Care. Required Immunizations The Early Childhood Health Assessment Record forms enclosed in the registration packet must be

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• [PDF File]State of Connecticut Department of Education Early ...

  https://info.5y1.org/ct-early-childhood-health-forms_1_e4344d.html

  I give my consent for my child’s health care provider and early childhood provider or health/nurse consultant/coordinator to discuss . the information on this form for confidential use in meeting my child’s health and educational needs in the early childhood program. Signature of Parent/Guardian Date

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