Get ready to apply
Hawaii Department of Health, Children with Special Health Needs Branch
Hiʻilei Developmental Screening Program
What you get
Free developmental screening, with results, activities, and information to help you plan your child’s next steps. Ask whether requests are open.
- Who starts it
- You
- How it’s sent
- PDF form, sent the way they ask
- Your time
- About 15 minutes
- Last checked
- Aug 27, 2026
-
What their form asksA preview, so you can gather things first. Fill it in on their site.
Open the application PDF ↗ Checked Aug 27, 2026What the form asks for
Published intake questionsChild’s Name / NicknameChild’s gender at birthChild’s Date of BirthWas he/she born early? If YES, by how many weeksParent/Primary Caregiver Name / RelationshipResidential Address / Mailing AddressPhone NumberEmailHow you heard about HiʻileiI would like to enroll in the FREE Hiʻilei Developmental Screening ProgramSignature of Parent/Primary CaregiverDate
After you send
Confirm receipt and respond to any eligibility or verification request. If you have not heard back in two weeks, write and ask whether it arrived.