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This document is a consent form for the School Health Care Program, provided by the Health Partnership Clinic (HPC) for offering medical, behavioral health, and dental services to students within
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How to fill out school-based portable care

01
Gather necessary documents: Ensure you have all required documents such as proof of address, identification, and any relevant medical records.
02
Complete the application form: Fill out the school-based portable care application form accurately, providing all requested information.
03
Provide supporting information: Attach any additional documents that support your application, such as letters of recommendation or assessments.
04
Submit the application: Send your completed application form and supporting documents to the designated school office or committee responsible for care services.
05
Follow up: After submission, follow up with the school to confirm receipt of your application and inquire about the review process.

Who needs school-based portable care?

01
Families with children who require additional support due to health or social factors.
02
Students with special educational needs who benefit from tailored care.
03
Parents or guardians seeking portable care options while their child is enrolled in school.
04
Children facing challenges such as behavioral issues, disabilities, or mental health concerns.
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School-based portable care refers to healthcare services provided to students within a school setting, allowing for immediate access to care without the need to leave school grounds.
Typically, healthcare providers or school administrators are required to file school-based portable care, especially when documenting services rendered to students.
To fill out school-based portable care, you should include the student's information, details of the services provided, date of service, and any follow-up recommendations.
The purpose of school-based portable care is to ensure that students have access to necessary healthcare services, promoting their health and well-being during school hours.
Information that must be reported includes the student's name, date of birth, services provided, dates of service, and any pertinent medical history or follow-up needs.
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School Health Care Program Health Partnership Clinic medical services behavioral health dental services consent form emergency contact patient information HIPAA compliance health history

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