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CCL. 029a Rev. 08/2011 Child Health Assessment The Child Health Assessment form is to be completed and signed by a nurse approved by KDHE to perform Child Health Assessments or a Licensed Physician.

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How to fill out ccl029amp029achildmedicalrecordimmunizationhistoryamphealthassessment

01

Start with the child's personal information, including name, date of birth, and address.

02

Enter the name and contact information of the child's parent or guardian.

03

Fill in the child's medical history, including any chronic conditions or allergies.

04

Document all immunizations the child has received, including dates and types of vaccines.

05

Include any health assessments that have been conducted, such as growth measurements and developmental screenings.

06

Make sure to sign and date the form after completion.

Who needs ccl029amp029achildmedicalrecordimmunizationhistoryamphealthassessment?

01

Parents or guardians who want to keep track of their child's immunization status.

02

Healthcare providers who need to assess the child's health.

03

Schools and childcare facilities that require proof of immunizations.

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What is ccl029amp029achildmedicalrecordimmunizationhistoryamphealthassessment?

CCL 029A is a form used to document a child's medical records, immunization history, and health assessment in accordance with state regulations.

Who is required to file ccl029amp029achildmedicalrecordimmunizationhistoryamphealthassessment?

Childcare providers and licensed facilities are required to file CCL 029A for each child enrolled in their program.

How to fill out ccl029amp029achildmedicalrecordimmunizationhistoryamphealthassessment?

To fill out CCL 029A, complete all sections related to the child's personal information, medical history, immunizations, and health assessment based on provided guidance and supporting documents.

What is the purpose of ccl029amp029achildmedicalrecordimmunizationhistoryamphealthassessment?

The purpose of CCL 029A is to ensure that all medical and immunization information for children in childcare is documented and complies with health and safety regulations.

What information must be reported on ccl029amp029achildmedicalrecordimmunizationhistoryamphealthassessment?

Required information includes the child's name, date of birth, immunization dates, medical conditions, allergies, and the provider's signature.

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