Health Checks for Wellness

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The Mary K Yap Foundation’s Health Assistance Program provides essential health and wellness checks 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 06

Wellness Health Checks

Enhance Well-being

Step 1 of 2

1) ORPHANAGE INFORMATION:

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(1) CONTACT INFORMATION *

Address Line 1

City

State / Province / Region

Postal Code

Country

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PAID EMPLOYEES

VOLUNTEERS

3) ORPHANAGE LEADERSHIP (Primary people in charge)

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4) CLASSIFICATION OF ORPHANS/NON ORPHANS

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Non Orphans (under 5)

Non Orphans (over 5)

Orphans (under 5)

Orphans (over 5)

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Grade

Non Orphans

Orphans

5) ENGLISH LANGUAGE SKILLS AMONG LEADERS:

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LEADER #1 *

SPEAK

READ

WRITE

LEADER #2 *

SPEAK

READ

WRITE

LEADER #3 *

SPEAK

READ

WRITE

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 will develop and implement the plan to ensure its effectiveness and relevance.

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

1. BASIC HEALTH INFORMATION:

(a) Provide children's names, ages, and genders. (attach a list on a separate Excel Sheet if required)

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No.

Name

Age

Gender

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(b) Do any of the children have known medical conditions and allergies?

2. IMMUNIZATION STATUS:

(a) Are all children up-to-date with their vaccinations?

(b) Do any children require catch-up vaccinations?

3. NUTRITION AND DIETARY NEEDS:

(a) Are there any dietary restrictions or specific nutritional needs for individual children?

(b) Is there access to balanced and nutritious meals?

4. PHYSICAL HEALTH:

(a) Do the children have regular access to healthcare professionals for check-ups?

(b) Are there any physical health concerns or complaints that need attention?

5. Mental Health and Emotional Well-being:

(a) Have any of the children exhibited signs of emotional or behavioral issues?

(b) Is there access to mental health professionals or counseling services?

6. Safety and Hygiene:

(a) Is the orphanage environment safe and free from hazards?

(b) Are there any recent injuries or accidents to report?

7. DEVELOPMENTAL MILESTONES:

(a) Are the children meeting appropriate developmental milestones for their ages?

(b) Are there any concerns about developmental delays or disabilities?

8. EDUCATIONAL AND SOCIAL NEEDS:

(a) Are the children attending school or receiving appropriate educational support?

(b) Are there any social integration or adjustment issues?

9. RESOURCES AND SUPPORT:

(a) Are there partnerships with local healthcare providers and organizations?

(b) Select all that apply for orphanages or children's homes homes that are needed to support the health and well-being of the children.

10. OTHERS: (explain in detail for h and i)

(a) Are there any cultural or religious preferences or practices that should be respected?

(b) Do the children have proper identification and documentation?

(d) Are staff members trained in basic first aid and CPR?

(e) Are there plans for regular health check-ups and assessments?

(f) Is there a reporting system for any significant health issues or incidents?

(g) Do the children or staff have any specific health concerns or suggestions for improvement?

(h) How will health information and updates be communicated to relevant stakeholders?

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(i) How will the health and well-being of the children be monitored over time?

Upload your Achievements Certificates, Recommendations Reference Letters, and Photos Collections of Health Checks for Wellness Experiences as necessary.

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The information provided in the above Health Checks for Wellness form is true and accurate. We accept that the information will be used only for evaluation by the relevant selection and funding committees. Once our orphanage is ready to receive assistance, a separate terms and disclosure agreement will be needed before receiving charitable support and donations. This form will need to be updated yearly.

Acknowledgment by Submitter: (Reg. Form 06 Rev.4 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 kindly send back the completed form as well as attach other useful information to (hello@marykyapfoundation.org or fax at +1415-463-8478)
(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

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FORM 06

Wellness Health Checks

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

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HEAD OFFICE:

PROJECT OFFICE:

PROGRAMS

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SEAL OF TRANSPARENCY