Get Dhmh Form 896 - Coned Howardcc

Filling out the DHMH Form 896 - Coned Howardcc is an essential step for ensuring that immunization records are accurately documented for children. This guide provides clear, step-by-step instructions for users to complete the form online effectively.

Follow the steps to complete the DHMH Form 896 - Coned Howardcc online

1. Click the ‘Get Form’ button to access the DHMH Form 896 - Coned Howardcc. This action will allow you to obtain the form and open it in your preferred editor.
2. Begin by entering the child’s name in the designated fields for last name, first name, and middle initial. Make sure to fill in the birthdate using the appropriate format.
3. Indicate the child’s county, school, and grade by filling in the respective fields accurately.
4. Provide the name and address of the parent or guardian in the corresponding sections, including a phone number and the city and ZIP code.
5. Record the immunizations in the section provided. Fill in the type of vaccine, the dose number, and the date administered for each vaccination listed.
6. If the child has a history of a specific disease related to immunization, fill in the appropriate section. Complete any additional information regarding other vaccines as indicated.
7. Obtain signatures from a medical provider, health department official, school official, or childcare provider in the designated certification sections. Ensure that the titles and dates are filled in accurately.
8. If the immunization records have been lost or destroyed, fill out the relevant section to certify this status. Make sure to sign and date it accordingly.
9. If the child is exempt from immunization for medical or religious reasons, complete the appropriate section, providing necessary details and signatures.
10. Once all sections are completed, save changes, download, print, or share the filled form as needed. Review the filled-out form for accuracy before final submission.

Complete your DHMH Form 896 - Coned Howardcc online today to ensure your child's immunization records are documented accurately.