Orientation and Child Health Intake Form (CHIF) Materials

Orientation and Materials for CYSHCN Coordinators

• CYSHCN Orientation (PDF)
• Children and Youth with Special Health Care Needs (CYSHCN) Team (PDF)
• Local Agency Coordinators and Support Staff (PDF)
• CYSHCN Care Coordination Toolkit (PDF)
• CYSHCN Managed Care Organization Referrals (PDF)
• Basecamp: Onboarding and Resources (PDF)
• Ordering CYSHCN Materials (PDF)
• Diagnostic and Treatment Funds (DxTx) Guidelines (PDF)
• Health Services Authorization (PDF)

Child Health Intake Form (CHIF) Information For Providers

• Child Health Intake Form (CHIF) (Word) | (PDF)
  • Formulario de Admisión de Salud Infantil (CHIF, por su sigla en inglés) (Spanish) (Word) | (PDF)
  • CHIF, форма о состоянии здоровья ребенка (Russian) (Word) | (PDF)
  • CHIF, Phiếu Tiếp Nhận Thông Tin Sức Khỏe Trẻ Em (Vietnamese) (Word) | (PDF)
• Child Health Intake Form (CHIF) Mapping - Should I CHIF? (PDF)
• Authorization to Release and Obtain Information (PDF)
  • Niños con necesidades médicas especiales Autorización para divulgar y obtener información (Spanish) (PDF)
  • Дети с особыми потребностями в медицинской помощи Разрешение на раскрытие и получение информации (Russian) (PDF)
  • Trẻ Em Có Nhu Cầu Chăm Sóc Sức Khỏe Đặc Biệt Cho Phép Tiết Lộ và Thu Thập Thông Tin (Vietnamese) (PDF)
• Managed File Transfer (MFT) Access Instructions (PDF)
• Data Collection Template (Excel)