Early Childhood Screening Forms

When you make an appointment for Early Childhood Screening, you will be mailed all the necessary paperwork to complete and bring to your appointment. If you lost this paperwork, need new copies, or did not receive the paperwork in time for your appointment, you can download and print the necessary forms here. Please contact our office with any questions! 763-792-6120

Screening Registration Form

Screening Consent Form

Child Health and Developmental History Form

If you wish to waive the early childhood screening requirement for your child, you can complete a conscientious objector form. Please submit to the Early Childhood office. 

Conscientious Objector/Waiver Form

If you choose to have your child screened at the doctor/clinic, please have your physician complete the following form and return to the Early Childhood office. 

Early Childhood Screening Summary Form - For Doctor