Get Mad 313 Form Nm

Filling out the Mad 313 Form in an accurate and timely manner is essential for notifying the appropriate authorities of a child's birth. This guide will provide a clear, step-by-step approach to completing the form online, ensuring all necessary information is submitted correctly.

Follow the steps to effectively complete the Mad 313 Form online.

1. Click ‘Get Form’ button to access the Mad 313 Form and open it in the editor.
2. In Section I, provide the hospital or medical provider's name, P.O. Box or street address, city, state, and zip code.
3. Proceed to Section II and enter the child's last name, first name, and middle name. Include the date of birth and select the gender by checking either 'Female' or 'Male'. A certified signature and telephone number must also be provided.
4. In Section III, input the mother’s last name, first name, and middle name, along with the date. Include their Social Security number and maiden name, their full address, and repeat similar details for the father's name and address. Indicate whether paternity has been established.
5. In Section IV, fill in the mother's Medicaid number from their Medicaid ID card. Check appropriate enrollment options under Managed Care Organizations if applicable.
6. Review all sections for accuracy, making necessary corrections as needed.
7. Once completed, save the changes made to the form. Users can also download, print, or share the form as required.

Complete the Mad 313 Form online today to ensure timely submission and processing.