Child Health Clinical Record Forms


LINK TO CHILD HEALTH RECORD FORMS then click on the “BROWSE only” icon - Under Main Menu click on the View Catalog Items link then click on Child Health Records located on the left navigational pane.

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. The forms are recommended for your use by Texas Health Steps; they are not required.

Please note that forms for ages 24 Months and 30 Months have been updated to reflect April 1, 2015, THSteps policy changes. The 24 Month form had formatting changes only. The 30 Month form required the addition of a checkbox to indicate whether or not an autism screening had been completed (if not done at the 24 month checkup), a checkbox to indicate that the M-CHAT had been used, and radio buttons to indicate a pass or fail result.

The Portable Document Format (PDF) forms include form fill fields (for example; text fields, check boxes) so that you can complete them online using Adobe Acrobat. Link to File Viewing Information located in the bottom tool bar of this web page for information on downloading Adobe Reader.

Instructions for Child Health Clinical Record Forms


Last updated March 31, 2015