Form preview

Get the free EARLY AND PERIODIC SCREENING, DIAGNOSTIC AND TREATMENT (EPSDT) PROGRAM

Get Form
16Women and Children's ServicesReviewed/Revised: 10/10/2017, 02/01/2017, 02/15/2016, 09/16/2015, 10/03/2014EARLY AND PERIODIC SCREENING, DIAGNOSTIC AND TREATMENT (EPS DT) PROGRAM Description EPS DT
We are not affiliated with any brand or entity on this form

Get, Create, Make and Sign early and periodic screening

Edit
Edit your early and periodic screening form online
Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.
Add
Add your legally-binding signature
Draw or type your signature, upload a signature image, or capture it with your digital camera.
Share
Share your form instantly
Email, fax, or share your early and periodic screening form via URL. You can also download, print, or export forms to your preferred cloud storage service.

How to edit early and periodic screening online

9.5
Ease of Setup
pdfFiller User Ratings on G2
9.0
Ease of Use
pdfFiller User Ratings on G2
Here are the steps you need to follow to get started with our professional PDF editor:
1
Create an account. Begin by choosing Start Free Trial and, if you are a new user, establish a profile.
2
Prepare a file. Use the Add New button. Then upload your file to the system from your device, importing it from internal mail, the cloud, or by adding its URL.
3
Edit early and periodic screening. Add and change text, add new objects, move pages, add watermarks and page numbers, and more. Then click Done when you're done editing and go to the Documents tab to merge or split the file. If you want to lock or unlock the file, click the lock or unlock button.
4
Get your file. Select the name of your file in the docs list and choose your preferred exporting method. You can download it as a PDF, save it in another format, send it by email, or transfer it to the cloud.
It's easier to work with documents with pdfFiller than you could have ever thought. You can sign up for an account to see for yourself.

Uncompromising security for your PDF editing and eSignature needs

Your private information is safe with pdfFiller. We employ end-to-end encryption, secure cloud storage, and advanced access control to protect your documents and maintain regulatory compliance.
GDPR
AICPA SOC 2
PCI
HIPAA
CCPA
FDA

How to fill out early and periodic screening

Illustration

How to fill out early and periodic screening

01
To fill out the early and periodic screening, follow these steps:
02
Gather all necessary information and forms.
03
Start by filling out the child's personal information, including name, date of birth, and address.
04
Provide information about the child's medical history, including any previous illnesses, surgeries, or hospitalizations.
05
Answer the screening questions pertaining to the child's development, behavior, and overall well-being.
06
Complete any additional sections or forms required by your healthcare provider or organization.
07
Review the completed screening for accuracy and completeness.
08
Sign and date the form as the parent or guardian.
09
Submit the filled-out early and periodic screening to the appropriate healthcare provider or organization for further processing and evaluation.
10
Keep a copy of the completed screening for your records.

Who needs early and periodic screening?

01
Early and periodic screening is typically recommended for children and adolescents under the age of 21.
02
It is especially important for children who receive Medicaid or other public health insurance.
03
However, early and periodic screening can be beneficial for any child as it helps identify any potential health or developmental issues early on.
04
Parents or guardians can consult with their child's healthcare provider to determine if their child needs early and periodic screening.
Fill form : Try Risk Free
Users Most Likely To Recommend - Summer 2025
Grid Leader in Small-Business - Summer 2025
High Performer - Summer 2025
Regional Leader - Summer 2025
Easiest To Do Business With - Summer 2025
Best Meets Requirements- Summer 2025
Rate the form
4.3
Satisfied
37 Votes

For pdfFiller’s FAQs

Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

Using pdfFiller's Gmail add-on, you can edit, fill out, and sign your early and periodic screening and other papers directly in your email. You may get it through Google Workspace Marketplace. Make better use of your time by handling your papers and eSignatures.
You may quickly make your eSignature using pdfFiller and then eSign your early and periodic screening right from your mailbox using pdfFiller's Gmail add-on. Please keep in mind that in order to preserve your signatures and signed papers, you must first create an account.
The easiest way to edit documents on a mobile device is using pdfFiller’s mobile-native apps for iOS and Android. You can download those from the Apple Store and Google Play, respectively. You can learn more about the apps here. Install and log in to the application to start editing early and periodic screening.
Early and periodic screening refers to a preventive health care program that provides comprehensive health assessments, vision and hearing tests, and other services to eligible individuals, particularly children.
Health care providers, clinics, hospitals, and other entities that participate in Medicaid are required to file early and periodic screening for eligible individuals.
Early and periodic screening can be filled out by following the guidelines provided by the Medicaid program and using the appropriate forms and documentation.
The purpose of early and periodic screening is to ensure that eligible individuals receive preventive health care services to promote early detection and treatment of health issues.
Information such as health assessments, vision and hearing tests, immunizations, and other relevant health history must be reported on early and periodic screening.
Fill out your early and periodic screening online with pdfFiller!

pdfFiller is an end-to-end solution for managing, creating, and editing documents and forms in the cloud. Save time and hassle by preparing your tax forms online.

Get started now
Form preview
If you believe that this page should be taken down, please follow our DMCA take down process here .
This form may include fields for payment information. Data entered in these fields is not covered by PCI DSS compliance.