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Child and Family Agency

Child and Family Agency

Strong | Safe | Supported

  • Services
    • Counseling
      • Child Guidance Clinic
      • Adult Outpatient Treatment
      • Open Access Hours
      • Community-Based Services
    • Urgent Crisis Center
    • School-Based Health Centers
      • Enrollment
      • Where we Operate
    • Community Bridge Clinic
    • Supportive Services
      • EARLY CARE And EDUCATION
      • Early Childhood Mental Health Consulting Program
      • Child Welfare Programs
      • family resource Centers
    • Forms
    • Billing and Insurance
      • Husky 4 Immigrants
    • Pay Your Bill
    • Patient Portal
    • Telehealth
  • About
    • Mission & History
    • Leadership
    • Advocacy
    • Other
      • Press Releases
      • 2022 Annual Report
      • 2022 Impact Report
      • 2021 – 2022 Audit
      • 990
      • CT State Single Audit
      • 2022-2024 Strategic Plan
      • Our Affiliations
  • Contact
    • Locations
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  • Careers
  • Events
  • Donate
    • Legacy Giving
    • 2023 Event Sponsorship Opportunities

Forms – Bright Futures Physical 9-10yrs


  • Bright Futures Physical Exam Pre-visit (9-10 years old) for Parents

  • MM slash DD slash YYYY
  • MM slash DD slash YYYY
  • Developmental Screening

  • Risk Assessment

  • Anemia

  • Hearing

  • Oral Health

  • Tuberculosis

  • Vision

  • Neighborhood and Family Violence (Bullying and Fighting)

  • Living Situation and Food Security

  • Alcohol and Drugs

  • Harm from the Internet

  • Emotional Security and Self-Esteem

  • Connectedness with Family and Peers

  • Your Child’s Development

  • School

  • Healthy Teeth

  • Nutrition

  • Physical Activity

  • Safety

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