Help Me Grow Resources

Referral Forms

If you would like to make a referral for a family seeking services and resources, please fill out the appropriate form below.

English Referral Form

Spanish Referral Form

Chinese Referral Form

Screening Passport

Use the passport to keep track of and share developmental screening history and results. Screening Passport

Learn the Signs. Act Early. 

These checklists are provided by the US Department of Health and Human Services. Special thanks to Help Me Grow Alameda County for the revised checklists. Click on the age of your child to see the milestones (available in English, Spanish and Chinese):

Milestone Checklists
2 months 18 months
4 months 2 years
6 months 3 years
9 months 4 years
1 year 5 years

Early Identification Guide for Medical Professionals

This guide was developed to help improve screening rates among medical professionals by
  • emphasizing the importance of universal developmental screenings;
  • providing information on screening tool use, methods of reimbursement and best practices;
  • clarifying when, where and how to refer families for services; and
  • recognizing Help Me Grow systems as a valuable resource, where available.

Well Visit Planner

The Well Visit Planner is available for families with children ages 0-6 to help you engage with your child’s pediatric provider. The tool take about 10 minutes to complete.

  • Discover issues and needs important to your child’s and family’s health
  • Learn about developmental milestones and important topics for children ages 0-6 years old. This
    includes information about your child’s growth, development, and language skills.
  • Pick what you want to discuss with your child’s health care provider. A Visit Guide will be created for
    you, based on questions you’ve identified as important for your family.
  • Partner with your child’s provider by sharing your questions and concerns in your Visit Guide

 

Developmental Journey Checklist

Parents can better track their child’s development, including developmental, social-emotional, and dental milestone markers with this checklist designed by the CDC’s Learn The Signs, Act Early! campaign and First 5 California, First 5 Association.