This form replaces all forms dated before February 24, 2009. This District of Columbia Universal Health Certificate (DCUHC) will be used for entry into Child Care Facilities, Head Start and DC public, private and parochial schools.

Exception: It cannot be used to replace EPSDT forms or the Department of Health Oral Health Assessment Form. The DCUHC was developed by the DC Department of Health and follows the American Academy of Pediatrics (AAP) guidelines for child and adolescent preventive health care from birth to 21 years of age. This form is a confidential document, consistent with the requirements of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) for health providers, and the Family Educational Rights and Privacy Act of 1974 (FERPA) for educational institutions.