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Iowa Child Health and Development Record
 
CHDR Forms in PDF format
1-4 weeks

2 months

4 months

6 months

9 months

12 months

15 months

18 months

2 years

3 years

4 years

5 years

6 years

7-8 years

9-10 years

11-17 years

 

Iowa Child Health and Development Record (CHDR) forms are used to guide and document a child’s health maintenance visits during the period from birth through age 5. These notes include developmental milestones and potential red flags for referral, and are based on the Iowa Recommended Schedule of EPSDT Care for Kids Screenings.

You can use the Iowa CHDR forms to help identify:

  • Risk factors in a child's life, such as nutrition concerns or family stressors  
  • Developmental "red flags" that signal the need for further assessment and evaluation of delay or potential for delay

Each age-appropriate Iowa CHDR form provides:

  • An easy-to-use screening checklist with space for notes and comments to help you identify emerging concerns
  • Screening components, including:
  •  Health care
  •  Developmental milestones and potential red flags
  •  Parental risk factors that signal the need for intervention
  •  Nutrition
  •  Medications
  •  Immunizations
  •  Lead screening
  • Space to note parental input about a child's development (parents are often the first to detect delay)

  • Anticipatory guidance information
  • Referral resources
  • A place to note the comprehensive health care plan and follow-up orders for the child

Iowa Child Health and Development Record were developed with assistance and input from the:

For more information about the Iowa Child Health and Development Record, please contact the EPSDT Provider Training Consultant.

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Home page About us | Screening | Services and supports | Billing codes |
Resources | Referrals | Site map |
Contact us | EPSDT Newsletter

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