Child’s Report of Health Examination
and Oral Health Assessment

In order to remain in compliance with the California Department of Education, CCS requires that each scholar enrolling in Kindergarten (or the first time entry in a CA public school) have a completed Health Examination and Oral Health Assessment Form.

Parents may waive the requirement by completing a waiver for both the health and oral requirement.

What If I Can’t Afford a Health or Oral Examination for My Scholar?
Some children may be eligible for a state-paid examination. Referrals to doctors and clinics are provided on request by the Child Health and Disability Prevention (CHDP) program coordinator of the local health department. Children through age 18 may receive a free checkup funded by CHDP if their families meet specific income guidelines. Most county health departments have a CHDP coordinator who can advise parents regarding eligibility.

To find out more about Child Health and Disability Prevention (CHDP) services or the application process, please contact your county CHDP office, which can be found on the “County Offices” page of the California Department of Health Care Services website. For more information on the CHDP, including a program overview and health check-up information, please view the CHDP Description of Services brochure.

**** Assessment and waiver forms are available through your Enrollment Advisor.