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Child Health Clinical Record Forms
 

The following documents are available in Adobe PDF format.

Use links below to download Child Health Clinical Record Forms. These forms are intended for use as a documentation tool for all required checkup components and should never be given out as a client questionnaire. Instructions are also available. The forms are recommended for your use by Texas Health Steps; they are not required.

The Portable Document Format (PDF) forms include form fill fields (for example; text fields, check boxes) so that you can complete them online using an Acrobat product such as Adobe Reader, Acrobat 3D, Acrobat Professional, or Acrobat Standard.

If you do not have Acrobat Reader, it is available free for Mac & PC at Adobe's website. Simply select the correct version for your particular computer and follow the directions provided.

Instructions for Child Health Clinical Record Forms [PDF 83KB]

PDF fileChild Health History Form ECH-1 [PDF 1,259KB] Revised 6/2011
PDF fileECH-2 Week [PDF 747KB]
PDF fileECH-2 Month [PDF 1,095KB]
PDF fileECH-4 Month [PDF 869KB]
PDF fileECH-6 Month [PDF 917KB]
PDF fileECH-9 Month [PDF 1,152KB]
PDF fileECH-12 Month [PDF 913KB]
PDF fileECH-15 Month [PDF 925KB]
PDF fileECH-18 Month [PDF 1,049KB]
PDF fileECH-24 Month [PDF 807KB]
PDF fileECH-30 Month [PDF 922KB]
PDF fileECH-3 Year [PDF 1,177KB]
PDF fileECH-4 Year [PDF 949KB]
PDF fileECH-5 Year [PDF 943KB]
PDF fileECH-6 Year [PDF 947KB]
PDF fileECH-7 Year [PDF 899KB]
PDF fileECH-8 Year [PDF 1,009KB]
PDF fileECH-9 Year [PDF 900KB]
PDF fileECH-10 Year [PDF 897KB]
PDF fileECH-11 Year [PDF 900KB]
PDF fileECH-12 Year [PDF 917KB]
PDF fileECH-13 Year [PDF 900KB]
PDF fileECH-14 Year [PDF 903KB]
PDF fileECH-15 Year [PDF 902KB]
PDF fileECH-16 Year [PDF 905KB]
PDF fileECH-17 Year [PDF 903KB]
PDF fileECH-18 Year [PDF 1,015KB]
PDF fileECH-19 Year [PDF 903KB]
PDF fileECH-20 Year [PDF 903KB]

 

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Community First Health Plans is an affiliate of the University Health System.