All forms are stored in PDF format unless indicated the type of format. (Updated October 2021)
Family Services
Enrollment Packets
- EHS Enrollmnet Packet
- Confidentiality Form
- Language Assessment
- Early Learning Behavior
- PFCE Family Goal Assessment
- Family Partnership Agreement Plan
- Family Serve Home Visit Form
- Operational Policies and Procedures Manual Confirmation Form
- Parent Interest Survey
- 2020-21 Parent Survey for Services (Traditional, Hybrid, or Virtual)
- 2021-22 Parent Survey for Services (Traditional, Hybrid, or Virtual)
Transition Packet
Application Forms
- Enrollment Application vB3
- Statement of Information Regarding Family Situation
- Outer Agency Referral Form
Personal Identifiable Information (PII)
- Notice Regarding PII – English
- Consent to Disclose PII Form – English
- Notice Regarding PII – Spanish
- Consent to Disclose PII Form – Spanish
Enrollment Request Form (To be used for 2021-21 Program Year)
Transfer Form
- Instructions and Procedures
- Early Head Start Program Transfer Form (Updated July 2021)
- Head Start Program Transfer Form (Updated July 2021)
Withdrawal Form
- Head Start/Early Head Start Withdrawl Procedures (Updated Oct. 2021)
- Head Start/Early Head Start Withdrawl Form (Updated Oct. 2021)
Center Forms
Parent Involvement
- PC Meeting – Announcement
- PC Meeting – Agenda
- PC Meeting – Sign In Roster
- PC Meeting – Presenter Agenda
- PC Meeting – Minuets (English & Spanish)
- Treasure’s Report
- Change of Meeting Date
- Donation Letter Request Form
- Fundraising Clearance Report
- Project Request
- Training Activity Log
HSPC
Early Head Start
- Early Head Start Folder Format
- Early Head Start Hearing Screening
- Early Head Start Vision Screening
- Permission Form – Insect Repellant
- Permission Form – Nature Walk
- Head Start-Early Head Start Health Summary
- Infant Care Instructions
- Infant Needs and Service Plan
Children Health Services
Health Record Booklet
- Completed Health Record Booklet (All Forms)
- Form 1 – General Information
- Form 2A – Health History
- Form 2B – Health History
- Form 3 – Physical Examination Assessment
- Form 5 – Dental Health
- Form 6 – Nutrition
- Form 9 – Psychological and Social Development
- Form 10 – Staff Observation of Health and Behavior
