Additional Health Department Forms

Forms for Special Child Health Services

Forms and Instructions
Form # Form Name/Title Linked File Instruction/ Comments
SCH-0 Special Child Health Services Registration Form
pdf (184k)
doc (205k)
Instructions and Legends (pdf 167k)
Instructions and Legends (doc 57k)
SCH-1 Autism Registration
(Updated November 16, 2016)
(This revised form is to be used in place of the SCH-0/SCH-1 combination.)
pdf (30k)
doc (158k)
(Updated November 16, 2016)
(pdf 21k) Instructions
(Updated November 16, 2016)
(doc 52k)  
SCH-2 Newborn Hearing Follow-Up Report
pdf (31k)
doc (77k)
Instructions (pdf 21k)
Instructions (doc 32k)
SCH-3 Lost to Hearing Follow Up Report
pdf (25k)
doc (63k)
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