Texas Health Steps Provider Forms

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Child Health Clinical Record Forms 


Texas Health Steps Provider Outreach Referral Form


Texas Health Steps Medical Checkup Forms

Providers may order LAB supplies by calling 512-776-7661 or online at http://www.dshs.state.tx.us/lab/mrs_forms.shtm#supplies.

THSteps Specimen Collection and Handling Guidance

Newborn Screening (NBS) Specimen Collection Form Presentation [PPT 412KB]


Registered nurses (RNs) without CNS, NP, or CNM certification may provide medical checkups only under direct physician supervision, meaning the physician is either on site during the checkup or immediately available to furnish assistance and direction to the RN during the checkup. When a physician has delegated a complete THSteps medical checkup to an RN, the physician must establish the RN’s competency to perform the service prior to the delegation as required by the physician’s scope of practice. The delegating physician provider is responsible for the direct supervision of the RN performing the delegated service and remains responsible for any service provided to the client. Prior to performing a checkup the RN must complete the required training modules which are included in this optional competency verification form. The RN or the RN’s employer must maintain documentation of course completion in the employee’s record.

Verification of Registered Nurse Competency to Perform Texas Health Steps Checkups form in DOC [1.03MB] or PDF [201KB]


Developmental Screening Forms

Ages and Stages

Modified Checklist for Autism in Toddlers (M-CHAT™) (Authorization for use of form, and translated forms available)

PEDS


Bright Futures - Prevention and health promotion for infants, children, adolescents, and their families. 


Growth Charts

CDC recommends that health care providers:

 

Last updated January 30, 2014