Children’s Services

Early Periodic Screening Diagnosis & Treatment (EPSDT)

• Autism Toolkit - Caring for children with Autism Spectrum Disorders - A Resource Toolkit for Clinicians. This requires a 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 health concerns or missed appointments.

Oral Health

• Pediatric Oral Health: Recommended Standard of Care (PDF)

Periodic Notices and Additional Resources

• For patients ages 0-2 (PDF)
• For patients ages 3-20 (PDF)
• Home Visit Referral Form (Word)
• Maine Immunization Program
• New Patient Informing Letter (PDF)
• Well Child Visit Pamphlet (PDF)
• Schedule for Well Child Visits (Word)

Well Child Visit Forms

• First Weeks (PDF)
• One Month (PDF)
• Two Months (PDF)
• Four Months (PDF)
• Six Months (PDF)
• Nine Months (PDF)
• Twelve Months (PDF)
• Fifteen Months (PDF)
• Eighteen Months (PDF)
• Two Years (PDF)
• Two and a Half Years (PDF)
• Three Years (PDF)
• Four Years (PDF)
• Five Years (PDF)
• Seven Years (PDF)
• Nine Years (PDF)
• Eleven Years (PDF)
• Fifteen Years (PDF)