Enrollment Application

Start the application for your child.

Inicie La Aplicación para su hijo.

Social Emotional Screening

Please complete the Social / Emotional screening for your child.

Por Favor complete la evaluación Social / Emocional para su niño.

Printable forms to take to your healthcare providers

Head Start Physical Examination/Assessment Form

Head Start Dental Exam Form

Early Head Start EPSDT Well Baby Assessment Form

Additional Enrollment Form Packet

This packet contains four additional forms required for enrollment.
• Consent – Rights and Responsibilities
• Release Authorization
• ETA -Emergency Transportation Authorization
• Health History

You can complete the packet and either email it to enrollment@hcesc.org or print the forms and bring them to your intake appointment with your child’s proof of age; your proof of residency; your child’s immunization history; and proof of income for the last 12 months.

Transportation Request Forms

Adobe Reader may be required for these forms, it can be downloaded here https://get.adobe.com/reader/ or from your app store for your smart phone.