Get Dss Form 1574 - South Carolina Department Of Social Services - Dss Sc

Filling out the DSS Form 1574 is an important step for prospective foster or adoptive parents in South Carolina. This guide provides clear and detailed instructions to help you complete the form accurately and efficiently online.

Follow the steps to successfully complete the form.

1. Click the ‘Get Form’ button to obtain the form and open it in your editor.
2. Enter the name of the person being examined in the provided field, ensuring the spelling is correct.
3. Fill in the birthdate of the individual in the designated area.
4. Authorize the release of medical information by indicating the licensed medical practitioner’s name.
5. Provide the patient’s signature and the date on which it is signed.
6. Medical practitioners should complete the summary of health conditions and medication use section, checking any applicable health conditions that the person has or has had in the past.
7. In the physical examination section, record pertinent measurements such as height, weight, and blood pressure.
8. Document any current medications, including their names and reasons for prescription, in the specified table.
9. Outline any chronic or progressive health conditions that may impede the individual's ability to care for a child in the next 5, 10, or 15 years.
10. List any illnesses, injuries, operations, or hospitalizations that occurred in the last 5 years.
11. Respond to questions regarding past medical evaluations or certifications necessary for the individual’s application for disability or worker’s compensation.
12. Have the physician certify that the individual is free from symptoms of communicable diseases and has no physical or cognitive limitations that would prevent parenting.
13. Enter the physician’s printed name, signature, address, and phone number at the end of the form.
14. Once all fields are completed, save your changes. You can then choose to download, print, or share the form as needed.

Complete your documents online to ensure a smooth application process.