All documents are in Adobe PDF format, unless otherwise indicated.

Health Record Forms

• Essentials of Job Corps Health & Wellness Charting (Medical, Oral Health, Mental Health and TEAP Charting) (HTML format)
• Quality Assurance - Health Records Audit Form (MS Word format)
• ETA 6-53 Job Corps Health Questionnaire, Instructions, and Documentation Guidance 
• SF-600 Chronological Record of Medical Care
• SF-603 Chronological Record of Dental Health Care
• SF-603A Chronological Record of Dental Health Care - continuation
• SF-88 Report of Medical Examination
• SF-93 Report of Medical History
• Immunization Forms (Job Corps Immunization Record, PPD Testing, INH Chemoprophylaxis) Revised March 2002
• Social Intake Form

Health Record Envelope

• ETA 6-135 Student Health Record Envelope
  North Texas JCC will no longer be supplying centers with student health record envelopes. Please download the Adobe file for this document and print on a 8 1/2 x 11 inch label that you can affix onto the appropriate sized envelope. Using a full-sized label will help ensure that the identifying information will not get lost or detached from the envelope. Labels can be purchased from most office supply stores/vendors.
• ETA 6-136 Student Health Folder
  North Texas JCC will no longer be supplying centers with student health record folders. Please download the Adobe file for this document and print on a 8 1/2 x 11 inch label that you can affix onto the appropriate sized folder. Using a full-sized label will help ensure that the identifying information will not get lost or detached from the folder. Labels can be purchased from most office supply stores/vendors.

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