HEAD START HEALTH REQUIREMENT INSTRUCTIONS     
						 
Child:                                                             Parent: _____________________________________
										            
Please read carefully
												
IMMUNIZATIONS OR IMMUNIZATION WAIVER

_______      Your child’s immunizations are up to date.

_______     Your child is due for immunizations; please contact your child’s doctor’s office or local health department to schedule  
                    an appointment to bring them up to date.  Free or low cost immunizations are available through your local health 
                    department if your child has no health coverage.

_______      You indicated at your preschool intake that you will be seeking a 2019 Immunization Waiver through your local health 
                    department, (for personal or religious reasons), or from your  child’s doctor, (for health reasons).  Please call for your 
                    appointment and send the waiver directly to us in the attached envelope after you receive the document. 

 WE MUST RECEIVE THIS BEFORE YOUR CHILD CAN START PRESCHOOL.
                     Please Note:  Head Start does not pay for Immunizations.		

PHYSICAL/HEALTH SCREEN

_______      Physical is up to date.  Please drop off enclosed physical form at your doctor’s office for completion.

_______      Head Start Physical required - make an appointment with your child’s physician (Medicaid or Health Insurance).                      
                    Take your form with you.  A completed physical form must be received within 30 days of your child’s initial attendance.

_______      If your child has no health insurance or Medicaid, we will contact you in August to help you schedule your child’s     physical with your local health department or another health professional. Head Start will be responsible for payment.                
	
If your child’s health coverage has changed or lapsed since we completed your child’s application,
Please contact Michelle Karns at 231-346-2117 to update your information.

DENTAL EXAM  
A DENTAL EXAM IS REQUIRED. Please take the enclosed Dental Health Record form to the appointment and send it back to us.

_______     As a current Medicaid recipient - make an appointment for your child with a dentist who accepts Medicaid (see the   enclosed Dental Resource Directory).  Take your child’s Medicaid card to the appointment. 

_______     Dental Insurance - make an appointment with a dentist who accepts your child’s dental insurance.  Take proof of dental insurance to the appointment.  This includes children who have Delta Healthy Kids Dental with their Medicaid coverage.  If your insurance covers only partial payment, Head Start will pay the balance.

_______     No insurance or Medicaid - make an appointment with a dentist of your choice from the enclosed Dental Resource 
                   Directory. Head Start will be responsible for payment for this exam.  Additional treatment / follow-up appointments must be pre-approved by the Head Start program.	

PLEASE NOTE:  

•	If you take your child to more than one dental exam during the school year, and Head Start paid for any part of the first exam’s cost, we cannot pay for the second exam.	

•	Physicals and Immunizations are requirements from the State of Michigan Department of Human Services Bureau of Children and Adult Licensing-Child Care Centers.  

•	Dentals are requirements from the Head Start Performance Standards.  Each child must complete this requirement if enrolled in a Head Start program.