Get Dss Form 2926

Filling out the Dss Form 2926 is essential for individuals working in child care to ensure health standards are met. This guide provides clear, step-by-step instructions on completing the form online, making the process straightforward and manageable.

Follow the steps to complete the Dss Form 2926 effectively.

1. Click ‘Get Form’ button to obtain the form and open it in the online editor.
2. Begin by entering your name and date of birth (DOB) in the designated fields at the top of the form.
3. In the section titled 'Type of Activity in Child Care,' check all applicable activities that you will be engaged in, such as food preparation or caring for children.
4. Proceed to Part I – Medical History, where you will need to answer questions regarding any medical problems. Select 'Yes' or 'No' for each question and prepare to provide explanations for any 'Yes' responses on the reverse of the form.
5. In Part II, answer each question regarding physical examination results such as vision, hearing, and blood pressure. Similar to Part I, provide explanations for any 'No' responses on the reverse side.
6. Complete Part III by indicating if there are any communicable diseases that might restrict your ability to work in a child care facility. If applicable, provide comments in the space provided.
7. If a tuberculosis certification is required, specify the type of test, reading, and date in the corresponding fields.
8. Review your immunization status in the designated area and confirm if it has been reviewed and provide any necessary comments.
9. Finally, complete the section for the health care provider by entering their name, address, telephone number, signature, and date of examination.
10. After filling out all sections, ensure that all changes are saved. You can then download or print the completed form for your records or submission.

Get started on completing your Dss Form 2926 online today!