Health Checks for Wellness

* indicates a required field.

The Mary K Yap Foundation’s Health Assistance Program provides essential health and wellness checks through the #LifeLine2026 campaign initiative for orphaned children. By collaborating with physicians, nurses, and medical associations, we work to ensure that every child receives the care they need to maintain their health and well-being. Our collective efforts focus on fostering a compassionate healthcare network that supports these vulnerable children and helps them thrive daily.

FORM 08

Wellness Health Checks

Enhance Well-being

Step 1 of 2

1) ORPHANAGE INFORMATION:

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Head Master:

Children:

Facebook / Website page:

Email Address: *

Years:

Telephone No:

(1) CONTACT INFORMATION *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

3) COULD YOU SPECIFY EACH CHILD'S GRADE LEVEL AND CLASSIFICATION AS AN ORPHAN OR NON-ORPHAN? *

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4) ORPHANAGE LEADERSHIP ON SITE? *

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5) ENGLISH LANGUAGE SKILLS AMONG SITE LEADERS: *

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The questions below should form the basis of a comprehensive health check services wellness plan for the orphanage, ensuring that the children’s physical, mental, and emotional needs are adequately addressed and monitored. Please include your responses on a separate piece of paper if required. A healthcare team member partner will develop and implement the plan to ensure its effectiveness and relevance.

The head orphanage/caretaker will initiate the form with the support of the Foundation's Orphanage Ambassador representatives (If Required)

6) IS THE ORPHANAGE MAINTAINING COMPLETE AND UPDATED IMMUNIZATION RECORDS FOR ALL CHILDREN? *

7) DO ANY CHILDREN REQUIRE CATCH-UP VACCINATIONS? (Check all that apply) *

8) DO YOU HAVE A LIST OF CHILDREN’S NAMES, AGES, AND GENDERS REQUIRING VACCINATIONS? *

Please load the children's names, ages, and gender needed for vaccinations.

9) IS THE ORPHANAGE PROVIDING BALANCED AND NUTRITIOUS MEALS THAT MEET THE DIETARY NEEDS OF ALL CHILDREN? *

10) DOES YOUR ORPHANAGE HAVE ACCESS TO BALANCE AND NUTRITIOUS MEALS? *

11) DO THE CHILDREN REGULARLY RECEIVE MEDICAL CHECK-UPS AND NECESSARY HEALTHCARE SUPPORT AT THE ORPHANAGE? *

12) HAS ANY OF THE CHILDREN EXHIBITED SIGNS OF EMOTIONAL AND BEHAVIORAL ISSUES? *

13) ARE THERE ACCESS TO MENTAL HEALTH PROFESSIONALS OR COUNSELING SERVICES TO ENSURE CHILDREN'S EMOTIONAL WELL-BEING? *

14) IS THE ORPHANAGE ENVIRONMENT MAINTAINED SAFELY WITH PROPER HYGIENE STANDARDS FOR ALL CHILDREN? *

15) ARE THERE PROPER HYGIENCE FACILITIES AND PRACTICES IN PLACE? *

16) ARE THERE ANY CONCERNS ABOUT DEVELOPMENTAL DELAYS OR DISABILITIES? *

17) ARE THE CHILDREN ATTENDING SCHOOL AND RECEIVING APPROPRIATE EDUCATIONAL SUPPORT? *

18) DO THE CHILDREN FROM YOUR ORPHANAGE HAVE ACCESS TO EXTRACURRICULAR ACTIVITIES AND PLAYTIME? *

19) DOES THE ORPHANAGE HAVE ADEQUATE RESOURCES TO SUPPORT CHILDREN’S HEALTH AND WELL-BEING? *

20) IS THERE ANYTHING ELSE YOU'D LIKE US TO KNOW ABOUT YOUR ORPHANAGE? *

Do you have achievement certificates, reference letters, or photo collections from any charitable experiences to upload? *

The information provided in the above Wellness Health Checks form is true and accurate. I accept the Terms and Conditions and Privacy Data Collection Policy. I agree that the relevant committees will only use the information for evaluation purpose. I will provide references upon request.

Acknowledgment by Submitter: (Reg. Form 08 Rev.5 2024) *

Address Line 1

Address Line 2

City

State / Province / Region

Country

Date *

Phone / Fax / Viber Number *

Email: / Signature: *

WAIVER AGREEMENT & PRIVACY DATA COLLECTION POLICY *

Please click to read and accept in order to proceed.

Please send other useful information to signup@marykyapfoundation or fax to +1 415 901-0305. (Eg. organizational mission and objectives, photos, press-release if available)

The information provided in the above volunteer form is true and accurate. I accept the Terms and Conditions, WAIVER AGREEMENT and PRIVACY DATA COLLECTION POLICY.

I acknowledge that the relevant committees will only use the information for evaluation. I will provide any character reference upon request and after the initial assessment.

Contacts

* indicates a required field.

FORM 08

Wellness Health Checks

The head orphanage/caretaker will initiate the form with the support of the Foundation's Orphanage Ambassador representatives (If Required)

HEAD OFFICE:

PROJECT OFFICE:

PROGRAMS

GET INVOLVED

SEAL OF TRANSPARENCY