Get Dhcs 5104

The Dhcs 5104 form is a crucial document required for obtaining fire clearance when providing substance use disorder treatment services. This guide aims to assist users in accurately completing the form online, ensuring compliance with local fire authority requirements.

Follow the steps to fill out the Dhcs 5104 form online.

1. Click the ‘Get Form’ button to access the Dhcs 5104 form and open it in your editor.
2. Begin by entering the address of the treatment program in the designated field. Ensure that all relevant suite numbers are included for clarity.
3. Next, input the telephone number of the program, ensuring it is a valid and reachable number.
4. In the section labeled 'Fire Authority Name,' provide the name of the local fire authority responsible for granting the clearance.
5. Complete the 'Name of Program' field with the official name of the substance abuse treatment program.
6. Have the inspector who performed the clearance inspection type or print their name and telephone number in the specified section.
7. The last field requires the signature and rank of the inspector granting clearance. Ensure this is filled out accurately.
8. Finally, date the inspection clearly to indicate when the clearance was granted. Make sure to include the official seal if applicable.
9. Once all fields are completed, save your changes, and consider downloading or printing the form for your records.

Encourage users to complete their documents online for efficiency and accuracy.