Get Ocfs Ldss 4433 Form

Filling out the Ocfs Ldss 4433 Form online is essential for providing a comprehensive medical statement for a child in childcare. This guide provides clear and user-friendly instructions to help you complete the form accurately.

Follow the steps to complete the Ocfs Ldss 4433 Form online.

1. Click the ‘Get Form’ button to obtain the form and open it in your preferred online editor.
2. Begin by entering the child's name and date of birth at the top of the form. Ensure that this information is accurate, as it is crucial for identification.
3. Provide the date of the examination in the designated field. This information is vital for tracking the child's health over time.
4. Indicate whether the child has received necessary immunizations by checking 'Yes' or 'No' for each listed immunization. If there are any medical exemptions, ensure to attach the necessary certification.
5. For each immunization, input the dates of administration clearly. If multiple doses are required, provide all relevant dates in the appropriate sections.
6. Complete the sections regarding any additional immunizations by specifying the type and the date they were administered.
7. Fill out the results from the Tuberculin Test and Lead Screening, attaching any required documentation for abnormal results.
8. Answer the health-specific questions regarding allergies, medications, special diets, and any conditions requiring attention. Be specific in your responses.
9. Provide a summary of the physical exam, including any special recommendations for daycare providers.
10. Ensure that the examiner signs the form, providing their name, address, phone number, and title. This signature is essential for validating the medical statement.
11. If applicable, indicate if a religious exemption from immunization is being claimed. Ensure that the parent or responsible person's signature, along with the date, is included.
12. Review the entire form for accuracy and completeness. Finally, you can save changes, download, print, or share the completed form as necessary.

Complete your documents online to ensure timely and accurate submission.