Medical Assessment Report
For Foster Care
Personal Details
Full Name
Date of Birth
Gender
Male
Female
Other
Current Address
Case/Child ID
Foster Care Details
Foster Parent/Carer Name
Placement Address
Date of Placement
Medical History
Summary of Medical History
Chronic Illnesses
Allergies
Current Medication
Immunisation Status
Physical Examination
Height
Weight
General Appearance
Findings
Mental and Emotional Health
Assessment
Observations
Developmental Assessment
Physical Development
Cognitive Development
Social/Communication Skills
Other Notes/Recommendations
Assessor Details
Name
Designation
Date of Assessment
Signature