Health Care Requirements & Forms


When a child comes into care in your home, you will need to complete a Comprehensive Intake Exam within 30 days of the child living in your home. See below for more details on how to get this done.

Every time the foster child in your home has a medical, dental or specialty visit (including CHDP examination), a medical provider needs to complete an 1132-C Medical/Dental Form and email/fax completed forms to or (415) 355-2357.

What you need to know

Children in the Child Welfare System (CWS) are at risk for unrecognized and untreated medical, dental, developmental and mental health problems. As youth with these special health care needs, children and adolescents in out-of-home placement require more frequent monitoring of their health status.

Health and Educational Passport (HEP)

All available medical records, assessments and histories are documented in the child’s Health and Educational Passport (HEP). This is part of the child’s permanent medical record and should be taken to all visits pertaining to the child. If providers need a copy, they may make a copy or obtain one from the Protective Services Worker (PSW), but you should always maintain a current copy of the HEP for your records and use. You can request an updated HEP from your PSW or Family and Children’s Services (FCS) Public Health Nurse (PHN).

Child Health and Disability Prevention (CHDP)

You must use the Child Health and Disability Prevention (CHDP) program for well-child physical exams. A CHDP examination is a thorough medical examination usually performed by a CHDP health care provider. Every child in out-of home placement is assigned a PHN. If you do not know where to take the child for a routine physical/dental exam, need assistance in scheduling an exam, or have any questions, contact your assigned PHN or call the Nurse of the Day (NOD) at (415) 558-2656.

Every child needs a medical and dental exam within 30 days of placement and thereafter. Here is a schedule of recommended medical and dental visits for kids. Bright Futures provides guidelines for all preventative care screenings and well-child visits. Please note: Dental exams begin at one year old and are required every six months. To learn more about prevention and health promotion for infants, children, adolescents, and their families, visit the Bright Futures website.

CHDP program information by county can be found here.

Comprehensive Intake Exam (CIE)

A health care provider needs to complete an 1132-C Health and Dental Form every time a child in your home has a medical, dental or specialty visit. This form can be emailed to or faxed to (415) 355-2357. This form or any reports should be sent as soon as possible after each visit for documentation purposes. Keep a copy for your files.

The City and County of San Francisco requires a Comprehensive Intake Exam (CIE) upon initial out-of home placement. It is only required once and is different from a routine well child exam. This exam helps establish a current health, mental, behavioral and developmental profile. It provides a complete health assessment: it is an opportunity to catch up on missing immunizations; it identifies needed treatments, allergies and referrals to any specialists.

The CIE takes place at San Francisco General Hospital (SFGH) Children’s Health Center (6M). All children placed in San Francisco County are required to go to SFGH. If you live out of county and cannot return to SFGH, please consult with your PHN or RFA SW on how this exam may be scheduled with a local CHDP provider. The provider will need to complete the 1736 CIE Out of County Form. The form will be provided by your Resource Family Approval (RFA) PSW. To reschedule or cancel a CIE, call (415) 557-5488 or email Please note: CIE are not scheduled through SFGH 6M. If you have any questions regarding the CIE, contact your RFA SW, PSW, PHN or call the NOD line.

Regulatory Requirements for dental and medical exams for children in foster care.

More information can be found here.

Age of Child Interval Until Next CHDP Exam
3-5 days after hospital discharge Within 1 month
By 1 month 1 month
2 months 2 months
4 months 2 months
6 months 3 months
9 months 3 months
12 months 3 months
15 months 3 months
18 months 6 months
24 months 6 months
30 months 6 months
3-21 years Every year