The Children’s HealthWatch survey instrument is administered during waiting periods in exam rooms in the Emergency Department or in Primary Care Clinics. During the survey, interviewers collect information about demographics, child health and development, parental health, housing, household food security, federal assistance program utilization, employment, income, financial literacy, dental care, utilities, childcare, and experiences of discrimination.

Click the links below to download the Children’s HealthWatch interview templates used for all patient interviews.

Children’s HealthWatch Interview in English

Children’s HealthWatch Interview in Spanish