Get Chdp Program Letter 01-11 - California Department Of Health Care ... - Dhcs Ca

This guide provides professional and comprehensive instructions on how to fill out the CHDP Program Letter 01-11 form accurately. It is designed to assist users by clearly outlining each section and field of the form to ensure proper submission to the California Department of Health Services.

Follow the steps to complete the CHDP Program Letter 01-11 online.

1. Click the ‘Get Form’ button to obtain the form and open it in your editor for editing.
2. Begin by entering the school code and selecting whether the reporting entity is a public school district or a private school. Make sure to provide accurate information as this step is crucial for proper identification.
3. Fill in the school year for which you are reporting. Be sure to enter the complete and correct year format.
4. Complete the sections that require the name and address of the reporting school. If the school has multiple locations, ensure the appropriate details for each location are included.
5. Input the total number of children enrolled in first grade. This data must accurately reflect the count at the time the report is prepared.
6. Record the number of children who have a health screening examination certificate. Make sure to verify this information against school records for accuracy.
7. Indicate the number of children whose parents or guardians have submitted waivers. This is critical for understanding screening exemptions.
8. Complete the fields related to the submission of health examination waivers and any children who have neither documentation nor a waiver.
9. In Box 22, mark whether reimbursement is desired by selecting YES or NO. This will determine how information is processed.
10. Once all sections are filled, review the entire form for completeness and accuracy, making corrections where necessary.
11. Save your changes, then print the report. Ensure you sign the original document where required before submission.
12. Send the signed original and any required copies to the local CHDP program by the designated deadline, retaining a copy for your records.

For further assistance, complete your CHDP Program Letter 01-11 online today.