Loading
Get Bcal 3704 2020-2026
How it works
-
Open form follow the instructions
-
Easily sign the form with your finger
-
Send filled & signed form or save
How to fill out the Bcal 3704 online
The Bcal 3704 is a crucial document used for medical clearance requests in the field of child and adult care in Michigan. This guide will walk you through the process of filling out this form online, ensuring that you complete each section accurately and efficiently.
Follow the steps to successfully fill out the Bcal 3704 online.
- Click the ‘Get Form’ button to obtain the form and open it in your preferred editor.
- In the applicant/licensee information section, fill in the facility/home name, license number, and address, including the city, state, and zip code. Also provide the licensing consultant's name, address, and phone number.
- Specify the license application type by selecting either adult foster care, child foster care, or child care, as applicable. Include the capacity of the facility.
- Move to the patient information section. The patient must provide their name, date of birth, address, social security number, city, state, and telephone number.
- In the release of information section, the patient must authorize the release of their medical information by providing their signature and date, along with their physician's name printed or typed.
- Next, the physician fills out the medical information section. They must confirm whether the individual has been tested for T.B., including the date of testing, test type, and results.
- The physician then describes the patient’s general physical and mental condition, indicating any health problems that would affect their ability to work with children or dependent adults.
- Provide additional comments as necessary and indicate if the physician would like to be contacted by the licensing consultant regarding their recommendation.
- Lastly, save your changes, and download or print the completed form for submission.
Complete your Bcal 3704 online today to ensure a smooth licensing process.
To submit a DMF to the Therapeutic Goods Administration (TGA), ensure you follow the specific requirements outlined in Bcal 3704. This often includes submitting electronic copies and ensuring compliance with regulatory standards. For assistance and accessing necessary forms, consider leveraging the US Legal Forms platform to facilitate your submission.
Industry-leading security and compliance
US Legal Forms protects your data by complying with industry-specific security standards.
-
In businnes since 199725+ years providing professional legal documents.
-
Accredited businessGuarantees that a business meets BBB accreditation standards in the US and Canada.
-
Secured by BraintreeValidated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.