Well child health examination forms that meet Medicaid EPSDT policy and the AAP periodicity schedule may be found on the AAP/Bright Futures web site at: https://brightfutures.aap.org/materials-and-tools/tool-and-resource-kit/Pages/default.aspx.
The Bright Futures Tool and Resource Kit provide forms and tools for health care providers, patients, and families to complete before, during, or after well-child visits. Core Tools include: Previsit Questionnaires, Visit Documentation Forms, and Parent/Patient Education Handouts for the following age categories:
- Infancy (Prenatal to 11 Months)
- Early Childhood (1 to 4 Years)
- Middle Childhood (5 to 10 Years)
- Adolescence (11 to 21 Years)
Supplemental tools are also available.
Note: The Bright Futures Tool and Resource Kit include materials available for download for review and reference purposes only. For any other use, to make multiple copies of specific items, or to incorporate forms into an Electronic Medical Record System, please contact email@example.com.
- Reminder Postcard for Parents(designed for Avery Laser Index and Postcard 5389)
- Michigan Head Start Association
- Alliance for Immunization in Michigan (AIM) Provider Toolkit
- CDC Immunization information
- MDCH Clearinghouse Resources
- State of Michigan Childhood Lead Poisoning Prevention Program
- Links to immunization and Lead Pamphlets and other MDHHS brochures
- Michigan Chapter of the American Academy of Pediatrics
- WIC Information