Required forms for outreach during the COVID-19 state of emergency (at NCFHP contract sites):
Additional recommended forms:
- 2021 Adolescent Health Assessment (English)
- 2021 Enabling Encounter Form
- Behavioral Health Screening Tool (RHS-15)
- Acute Illness Reporting Form and Protocol (AIR)
- Optional questions ADULT
- Optional questions ADOLESCENT
- Optional questions PEDIATRIC
- 2020 Medical Encounter Form (2021 Coming Soon)
- Behavioral Health Encounter Form
- Site Register
- Migrant Clinicians Network (MCN) Enrollment Form English
- Migrant Clinicians Network (MCN) Enrollment Form Spanish