Forms for Appointments
Is your next appointment a certification? You can save time by completing these forms from home.
If mom is being certified, complete the Women’s Questionnaire
For children 1-4 complete the Child’s Questionnaire
For infants less than 12 months old use the Infant Questionnaire.
AIDS
www.choice-philadelphia.org
Breastfeeding
http://www.womenshealth.gov/breastfeeding/
http://www.babycenter.com/breastfeeding-basics
Car Seats / Bike Helmets
www.pasafekids.org or
www.nhtsa.dot.gov
Child Care / Day Care
www.dhs.pa.gov
Child Support (Domestic Relations)
www.childsupport.state.pa.us
Childhood Immunization
www.health.state.pa.us
(Health Topics A-Z, Immunizations)
Childhood Lead Poisoning
www.health.state.pa.us
(Health Topics A-Z, Lead Poisoning Prevention)
Children’s Health Insurance Program (CHIP)
www.chipcoverspakids.com
Drug and Alcohol
www.ddap.pa.gov
(Need Help Now?)
Education
www.literacydirectory.org
Emergency Food Providers and Food Pantries
www.feedingamerica.org
FDA Food and Safety Recalls
http://www.fda.gov/Safety/Recalls/default.htm
Head Start / Early Head Start Programs
www.paheadstart.org
Healthy Baby Line
www.dhs.pa.gov
Help in PA
www.helpinpa.state.pa.us
Mental Health & Substance Abuse Services
www.dhs.pa.gov
Migrant Education Program
www.education.state.pa.us
National Domestic Violence Hotline
www.thehotline.org
National Hispanic Family Health Hotline
www.hispanichealth.org
PA WIC
www.pawic.com
School Breakfast, Lunch, and Summer Food Programs
www.education.state.pa.us
Sexually Transmitted Diseases
www.health.state.pa.us
(Health Topics A-Z, Sexually Transmitted Diseases)
Special Kids Network System of Care
www.health.state.pa.us
(Health Topics, Special Kids Network)
Text4Baby
www.text4baby.org
Welfare Helpline
www.dhs.pa.gov
Forms for Appointments
Tapestry of Health WIC Program