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D. R.L. 112 3 6 S.S.L. 373-a Form 1-D Child s Medical History - Agency or Private-Placement 12/97 FAMILY COURT OF THE STATE OF NEW YORK COUNTY OF In the Matter of the Adoption of A Child whose First Name is Docket File No. 1.

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How to fill out the Ssl 373 A Form online

Filling out the Ssl 373 A Form online can streamline the process of providing essential medical information for adoption cases. This guide will walk you through each section of the form to ensure you complete it correctly and efficiently.

Follow the steps to fill out the Ssl 373 A Form online.

  1. Click ‘Get Form’ button to access the form and open it in your preferred editor.
  2. Begin with section one, which asks for the child's age and date of birth. Enter these details accurately in the specified fields.
  3. Proceed to section two, where you will indicate any illnesses or health problems the child has experienced. Check the appropriate boxes and specify any additional conditions in the provided space.
  4. In section three, provide the dates for the child’s immunizations. It is essential to list all relevant vaccines, ensuring you fill in all fields as required.
  5. Section four focuses on prenatal history. Indicate any complications during the pregnancy and delivery, detailing any necessary conditions and specifics as requested.
  6. For section five, list any congenital impairments or physical defects if applicable. Be thorough in your descriptions.
  7. In section six, state the present health of the child and include the ages at which any known causes of death occurred in the family history.
  8. For sections seven and eight, provide medical history regarding the birth mother and father, checking applicable boxes and adding further details as necessary.
  9. Once you have completed all sections, review the entire form for accuracy. Make any necessary changes before finalizing your submission.
  10. Finally, save your changes, and choose to download, print, or share the completed form as required.

Start filling out your Ssl 373 A Form online today to ensure a smooth adoption process.

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