Head Start / ECEAP forms and documents

Agreement form  CCS 97-141
Application CCS 9847
Application information sheet
Authorization to disclose and receive information  CCS 9713
Child care exceptional fees  CCS 9611
Child protective services report  CCS 97-104
Consent for screening, assessment and exchange of information  CCS 97-150
Continuing enrollment agreement  CCS 98-134
Dental examination record  CCS 9821
DST family documentation  CCS 98-132a
ECEAP forms and documents
Education completion dates summary  CCS 9874
Enrollment eligibility priority checklist 2009-10  CCS 98-126
Family strengths and partnership agreement/goals worksheet  CCS 98-129
Field trip permission (group)  CCS 9860
Financial agreement  CCS 9610
First-aid kit inventory checklist  CCS 9887
Fluoride information handout
Flouride information handout (Spanish)
Food request  CCS 97-121
Health, dental and diet history  CCS 98-116
Health requirements reminder  CCS 9888
Immunization notice (30-day) CCS 9854
Income statement  CCS 9849
Initial child development plans (CIP)
         I/T home-based  CCS 98-144
         I/T center-based  CCS 98-145
         PS  CCS 98-146
Infant/toddler daily staffing plan I  CCS 9864
Infant/toddler daily staffing plan II  CCS 9865
In-kind records
        Interagency meeting CCS 9840
        Donation receipt  CCS 9794
        Community volunteer  CCS 9795
        Parent volunteer hours  CCS 9796
Lead exposure risk  CCS 9897
Lead handout  CCS 98-137
Medication administration authorization  CCS 9896
Mental health consultant documentation  CCS 98-124
Mental health consultant PIR log  CCS 98-125
Minor incident/accident/illness report  CCS 98-123
New employee orientation checklist  CCS 98-136
Notice of privacy (English)  CCS 98-121
Notice of privacy (Spanish)  CCS 98-147
Practical dress guidelines for early childhood classroom and
work environments  CCS 98-143
Pre-employment medical exam  CCS 98-110
Pre-employment medical exam instructions  CCS 98-118
Release and emergency treatment authorization  CCS 9828
Request for volunteer vendor number  CCS 98-142
Sensory/growth screening results  CCS 9824
Special diet letter  CCS 98-140
Special diet request  CCS 98-141
Standards of conduct agreement  CCS 9878
Table of contents: Child/family file (CENTER)  CCS 98-139
Table of contents: Child/family file (HOME)  CCS 98-138
Training/travel request-staff  CCS 98-102
Transition plan checklist  CCS 98-135
Well-child examination record  CCS 9822