Skip to main content
Oregon.gov Homepage

EI/ECSE Forms - Medical Screening Forms

 
Health Screening Checklist - 581-1378-E
PDF
RTF 

Health Screening Followup Report Example
PDF
RTF

Health Screening Followup Report-Instructions
PDF
RTF

Health Screening Guidelines
PDF
RTF

Health Screening Process Flowchart

Hearing Screening Checklist - 581-1377-E 
PDF
RTF 

Hearing Screening Guidelines
PDF
RTF

Hearing Screening Process Flowchart
PDF
RTF

Vision Screening Checklist - 581-1379-E 
PDF
RTF 

Vision Screening Guidelines
PDF
RTF

Vision Screening Process Flowchart
PDF
RTF
 

Your browser is out-of-date! It has known security flaws and may not display all features of this and other websites. Learn how

×