Health checks and records for a child entering care
Differs between the US and Canada
The health standards below are American Academy of Pediatrics
recommendations. They are professional standards rather than law, which
matters: what a child actually receives is determined by state child
welfare policy and Medicaid, and Canada has no equivalent standard in
force.
What a child entering care should receive
- A health screening visit within 72 hours of
placement. - A comprehensive health admission visit within 30
days, covering mental health, development for under-sixes,
education for over-fives, and dental. - A follow-up at 60 to 90 days to monitor
adjustment, referrals and medication.
Ongoing frequency: monthly to six months old, every three months to
twenty-four months, then twice yearly to twenty-one.
For a newly adopted child
An evaluation as soon as possible, covering whatever
medical background exists, a full physical, newborn screening
panels, hearing, vision and dental, formal developmental and
behavioural screening, and immunisation catch-up.
Nutritional assessment is worth asking for specifically. Iron,
calcium and vitamin D deficiency occur in domestically adopted
children, not only in children adopted from abroad.
The records checklist
Ask for these in writing. Some will not exist, and knowing
what is missing is itself useful.
- Birth records and newborn screening results
- The complete immunisation record
- Prior primary care and specialist records
- Hospital and emergency department history
- Current medications, including any psychotropic
medication and who consented to it - Developmental and mental health assessments
- Dental, hearing and vision records
- Known family medical and genetic history
The AAP publishes consent forms for obtaining and releasing
confidential records. They are worth having before you need
them.
Consent rules are local
Who may consent to routine care, to mental health
treatment and to psychotropic medication for a child in care is set
by state or provincial law, as is what must be disclosed to
prospective adoptive parents. Ask your agency for its own policy in
writing.
What to do next
Before or at placement, ask for the records list above and
for written confirmation of who holds medical consent. Both are much
harder to obtain once a placement is settled and nobody is
expecting the question.
Sources
- American Academy of Pediatrics, foster care health care standards
- American Academy of Pediatrics, primary care tools including consent and records forms
Facts on this page were checked against the sources above on 20 August 2026. Rules change. If you are making a decision, confirm the detail with the agency responsible for your area.
