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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:
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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
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Each age-appropriate
Iowa CHDR form provides:
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An
easy-to-use screening checklist with space for notes
and comments to help you identify emerging concerns
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Screening
components, including:
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Health
care
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Developmental
milestones and potential red flags
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Parental
risk factors that signal the need for intervention
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Nutrition
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Medications
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Immunizations
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Lead
screening
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CHDR Forms
in PDF format |
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1-2 weeks
2 months
4 months
6 months
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9 months
12 months
15 months
18 months
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2 years
3 years
4 years
5 years |
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CHDR Form Components in MS Word
Format
In response to requests from
those of you who use electronic records, three components of the CHDR
forms are now available in MSWord format:
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Milestones
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Social history
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Plan of care
This format allows easier insertion of this information into electronic
records, and enhances documentation of the
screening components of
comprehensive, periodic well-child assessment, as well as
documentation of referrals and follow-up care.
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1-2weeks
2 months
4 months
6 months
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9 months
12 months
15 months
18 months
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2 years
3 years
4 years
5 years
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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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