Child Health Clinical Record Forms

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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. 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 [PDF 4.29MB] Revised April 2013

Child Health History Form ECHR-1 [PDF 1.33MB]

All Child Health Clinical Record Forms shown below were revised April and May 2013

Child Health Clinical Record Forms
ECHR-5 Day [PDF 271KB]
ECHR-2 Week [PDF 270KB]
ECHR-2 Month [PDF 405KB]
ECHR-4 Month [PDF 272KB]
ECHR-6 Month [PDF 345KB]
ECHR-9 Month [PDF 317KB]
ECHR-12 Month [PDF 332KB]
ECHR-15 Month [PDF 318KB]
ECHR-18 Month [PDF 328KB]
ECHR-24 Month [PDF 330KB]
ECHR-30 Month [PDF 304KB]
ECHR-3 Year [PDF 376KB]
ECHR-4 Year [PDF 732KB]
ECHR-5 Year [PDF 738KB]
ECHR-6 Year [PDF 731KB]
ECHR-7 Year [PDF 704KB]
ECHR-8 Year [PDF 702KB]
ECHR-9 Year [PDF 704KB]
ECHR-10 Year [PDF 701KB]
ECHR-11 Year [PDF 703KB]
ECHR-12 Year [PDF 704KB]
ECHR-13 Year [PDF 703KB]
ECHR-14 Year [PDF 706KB]
ECHR-15 Year [PDF 705KB]
ECHR-16 Year [PDF 706KB]
ECHR-17 Year [PDF 706KB]
ECHR-18 Year [PDF 705KB]
ECHR-19 Year [PDF 706KB]
ECHR-20 Year [PDF 706KB]
ECHR-19-20 Year [PDF 706KB]

Last updated May 21, 2013