Is this child fully immunised for their Yes/No age? Immunisations required: Health history Personal health history (complete if no previous information available or update as necessary) (complete if no previous information available or update as necessary) Family history Regular medication/equipment required Allergies/adverse reactions to medication, food or animals Physical examination Date Age General appearance/presentation Growth Height cm centile Weight kg centile OFC cm centile Any concerns about BMI growth/weight? Vision (as indicated) Hearing (as indicated) Skin and hair care (e.g. eczema, hygiene, athlete’s foot, ingrown toenails, verrucae)
Is this child fully immunised for their age? Yes/No Immunisations required: Health history Personal health history (complete if no previous information available or update as necessary) Family history (complete if no previous information available or update as necessary) Regular medication/equipment required Allergies/adverse reactions to medication, food or animals Physical examination Date Age General appearance/presentation Growth Height cm centile Weight kg centile OFC cm centile Any concerns about growth/weight? BMI Vision (as indicated) Hearing (as indicated) Skin and hair care (e.g. eczema, hygiene, athlete’s foot, ingrown toenails, verrucae)