The Michigan Health Appraisal Form MDHHS-3305 is the health report Michigan childcare centers, preschools, and Head Start programs require before a child can attend. You fill out the personal and health history sections, a doctor completes the physical exam and signs it, a dentist completes the dental section, and the finished form goes to the childcare provider, which must have it on file within 30 days of your child’s first day.
Where to Get the Form
Most childcare centers hand out blank copies during enrollment. If yours doesn’t, the form is a free PDF download from the Michigan Department of Health and Human Services and from the Michigan Department of Lifelong Education, Advancement, and Potential (MiLEAP), which oversees childcare licensing through the Child Care Licensing Bureau.1Michigan Department of Lifelong Education, Advancement, and Potential. Child Care Licensing Your pediatrician’s office may also stock copies. Bring your child’s immunization records to the appointment; you’ll need them for the form.
Make sure you’re using the current MDHHS-3305. An older version circulated as BCAL-3730 under a previous agency name and is no longer accepted.
What You Fill In Before the Appointment
The first two sections are the parent or guardian’s responsibility. Complete them before the doctor’s visit so the examiner can review your answers during the exam.
Personal Information
Section 1 asks for the child’s full legal name, date of birth, home address, and the date. You also enter your own name, address, and phone numbers (home or cell, plus work).2Michigan Department of Health and Human Services. MDHHS-3305 Health Appraisal Form Make sure the child’s name exactly matches the rest of your enrollment paperwork. Mismatches between forms can stall things at the center.
Health History
Section 2 is a checklist for ongoing health concerns, with prompts for areas like breathing, skin conditions, allergies, seizures, and behavioral or developmental concerns.2Michigan Department of Health and Human Services. MDHHS-3305 Health Appraisal Form Be thorough. The doctor uses your answers to guide the exam, and the center uses them to plan accommodations. If your child takes daily medication or carries an inhaler or epinephrine auto-injector, note it here.
What the Doctor and Dentist Complete
Everything from Section 3 onward is for a licensed medical or dental professional. The physical exam, vision and hearing screenings, immunization review, tuberculosis risk assessment, dental evaluation, and examiner signature all live in these sections.2Michigan Department of Health and Human Services. MDHHS-3305 Health Appraisal Form
Physical Exam, Tests, and Measurements
The examiner records the child’s height, weight, blood pressure, and physical exam findings. Vision screening covers visual acuity and muscle imbalance. Hearing screening is done by audiometer, otoacoustic emissions (OAE), or another method, with separate results for each ear. Michigan law requires vision and hearing testing for any child enrolling in school or childcare for the first time.3Michigan Department of Health and Human Services. MDHHS-3305 Health Appraisal The doctor also notes any activity restrictions the center needs to know about, such as a heart condition that limits physical play or a food allergy requiring a menu adjustment.
Tuberculosis Risk Assessment
The form includes a pediatric tuberculosis risk assessment. The doctor answers a short set of screening questions to decide whether an actual TB test is needed. A link and QR code for Michigan’s official pediatric TB risk assessment tool appear on the form.2Michigan Department of Health and Human Services. MDHHS-3305 Health Appraisal Form Most children won’t need further testing. If the screen flags a concern, the doctor will order a skin test or blood test before signing off.
Dental Exam
Section 6 requires a dentist, dental therapist, or dental hygienist to record whether the child has treated decay, untreated decay, or no findings, and to check a recommendation: routine care, referral for dental treatment, or referral for urgent dental care.2Michigan Department of Health and Human Services. MDHHS-3305 Health Appraisal Form You may need two appointments to fully complete the form, one medical and one dental. Schedule both early so you aren’t scrambling before the enrollment deadline.
Examiner’s Signature
The form isn’t valid without the examining professional’s printed name, degree or license type, phone number, signature, and the date of the examination.2Michigan Department of Health and Human Services. MDHHS-3305 Health Appraisal Form Under Michigan licensing rules, the evaluation can be signed by the physician or the physician’s designee, which includes physician assistants and nurse practitioners acting under a physician’s authority.4Legal Information Institute. Michigan Admin Code R 400.8112 – Children’s Records Check every field before you leave the office. A missing signature or date is the most common reason a childcare center sends the form back.
How Recent the Physical Must Be
Michigan does not use a single twelve-month window for every age. The licensing rules measure freshness backward from your child’s first day of attendance, not from the enrollment date:4Legal Information Institute. Michigan Admin Code R 400.8112 – Children’s Records
- Infants: within the preceding 3 months.
- Toddlers: within the preceding 6 months.
- Preschoolers: within the preceding 12 months.
So an infant’s four-month-old well-child visit is already too old to serve as the enrollment physical. The three-month window for infants is tight, so plan accordingly.
Immunizations and Waivers
At enrollment, the center must have either a certificate of immunization showing at least one dose of each required vaccine, or a signed waiver. If your child’s immunizations aren’t fully up to date at enrollment, you have four months to deliver an updated certificate showing completion of the remaining doses, unless a licensed provider has signed a statement confirming immunizations are in progress.4Legal Information Institute. Michigan Admin Code R 400.8112 – Children’s Records
If you choose not to vaccinate, Michigan requires you to visit your county health department in person. A health department educator walks you through the benefits of vaccination and the risks of the diseases involved. After that session, you receive the official State of Michigan nonmedical waiver form, which you sign and provide to the childcare center.5Michigan Department of Health and Human Services. Immunization Waiver Information for Local Health Departments The current version of the nonmedical waiver form is dated January 2024. Medical exemptions come from your child’s doctor and do not require a health department visit.
Submitting the Form and the 30-Day Rule
The completed MDHHS-3305 goes to the childcare center administrator. Michigan licensing rules give you a 30-day grace period after your child’s first day of attendance to get the form on file, though many centers require it before day one.4Legal Information Institute. Michigan Admin Code R 400.8112 – Children’s Records Ask during enrollment so you know your actual deadline. The center must keep the form accessible on-site, because state licensing consultants can ask to see it during any inspection.
An electronic record printed from the physician’s office is accepted in place of the original paper form.4Legal Information Institute. Michigan Admin Code R 400.8112 – Children’s Records If your pediatrician uses an electronic health record system, ask for a printout that includes every field MDHHS-3305 covers, especially the signature, restrictions, and exam date.
Keeping the Form Current
The health appraisal isn’t one and done. Michigan requires updated physical evaluations on a rolling schedule measured from the previous evaluation date:4Legal Information Institute. Michigan Admin Code R 400.8112 – Children’s Records
- Infants and toddlers: every 13 months (effectively yearly).
- Preschoolers: every 2 years.
Set a calendar reminder a month before each deadline so you have time to book the appointment and get the updated form to the center without a gap.
Alternatives for School-Age Children, Religious Objections, and Head Start
School-age children in childcare don’t need a physician-completed MDHHS-3305. Instead, a parent signs a statement each year confirming the child is in good health (with any activity restrictions noted), that immunizations are up to date, and that the immunization record or waiver is on file at the child’s school.4Legal Information Institute. Michigan Admin Code R 400.8112 – Children’s Records
If you object to a physical examination on religious grounds, you can give the childcare center a signed statement annually declaring that your child is in good health and that you accept responsibility for the child’s health while in care.4Legal Information Institute. Michigan Admin Code R 400.8112 – Children’s Records This option is also written into the Child Care Organizations Act itself.6Justia Law. Michigan Act 116 of 1973 – Child Care Organizations
Head Start and Early Head Start programs use the same MDHHS-3305, but federal rules add requirements on top. The form notes that Head Start programs need a determination that the child is up to date on age-appropriate preventive and primary health care, covering medical, dental, and mental health, following the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) schedule and the CDC immunization schedule.2Michigan Department of Health and Human Services. MDHHS-3305 Health Appraisal Form Federal regulations require Head Start programs to obtain those professional determinations within 90 calendar days of a child’s first day. Programs running 90 days or fewer have just 30 days.7eCFR. 45 CFR 1302.42 – Child Health Status and Care Expect the doctor to order bloodwork if your child hasn’t had recent labs, since an EPSDT well-child exam includes blood tests for anemia at age-based intervals.