Early Periodic Screening Diagnosis & Treatment (EPSDT)
- Autism Toolkit - Caring for children with Autism Spectrum Disorders - A Resource Toolkit for Clinicians. Requires User Name and Password.
- Member Education Request Form (MERF) - This form replaces the BF 19 form used previously and is a request to educate a member about heath concerns or missed appointments.
- Pediatric Preventive Health Screenings (.pdf)
- Maine Well Child Visit Forms
- Maine Well Child Visit Form Letter (.doc)
- Maine's Parent/Patient Education Handouts
- D0145: Oral Evaluation of Children Three Years by Medical Providers (.pdf)
- Pediatric Oral Health: Recommended Standard of Care (.pdf)
- Fact Sheet for Parents (.doc)
- Overview for Health Professionals (.pdf)
- Maine Oral Health Program (Maine CDC website)
Periodic Notice and Additional Resources
- For patients ages 0-2 (.pdf)
- For patients ages 3-20 (.pdf)
- Schedule for Well Child Visits (.doc)
- Home Visit Referral Form (.doc)
- Maine Immunization Program
- New Patient Informing Letter (.pdf)
- Well Child Visit Brochure (.pdf)
Contact Trista Collins at 207-624-4094, with questions.