Please click on Enrollment Forms and Child Health Assessment to start the enrollment process. The Child Health Assessment will need to be printed and filled out and signed by a nurse approved by KDHE to perform Child Health Assessments or a Licensed Physician. If a Physician Assistant (PA) completes the Child Health Assessment, the signature of the Licensed Physician authorizing the PA is to be included at the bottom of the form. If you don't have access to a printer, please call 620.615. 5850 and request the Child Health Assessment Form or stop by the EEC at 303 East Bigger St. to pick one up.

Enrollment Forms - Please contact EEC for more information

**Please note that all fields that are required in the enrollment forms will be indicated with an orange triangle on the top left-hand side. You will not be able to submit the forms until all required information has been filled out. If it does not apply, please indicate by typing NA.**

If you have access to a printer, please click on Child Health Assessment below, fill in child's name and date of birth and then print out. If you don't have access to a printer, please call 620.615.5850 and request the Child Health Assessment Form or stop by the EEC at 303 East Bigger St. to pick one up.

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