New Healthy Start Data Collection Forms
In February 2024, OMB approved revised data collection forms for the Healthy Start program. All Healthy Start programs are required to screen participants using the four Healthy Start Data Collection Forms (Demographic Form, Background Form, Prenatal Form, and Parent/Child Form). Prior to screening, Healthy Start staff must be trained in implementing the forms.
Healthy Start Data Collection Forms:
- Demographic Form PDF | Fillable PDF | Word | Spanish PDF | Fillable Spanish PDF
- Background Form PDF | Fillable PDF | Word | Spanish PDF | Fillable Spanish PDF
- Prenatal Form PDF | Fillable PDF | Word | Spanish PDF | Fillable Spanish PDF
- Parent/Child Form PDF | Fillable PDF | Word | Spanish PDF | Fillable Spanish PDF
Data Collection Forms Training
On behalf of the Division of Healthy Start and Perinatal Services (DHSPS), the Healthy Start TA & Support Center (TASC) hosted a Healthy Start Data Collection Forms training in June 2024. During this training, staff from DHSPS discussed the implementation of the revised data collection forms for the 2024-2029 grant cycle. View the training slides here.
Please direct any questions about the new forms or data collection to the HS data team at HealthyStartData@hrsa.gov. In the subject line of your email, please indicate what your question pertains to (e.g., CareWare, HSMED, Data Collection Forms).