Get Please Fax Completed Form To: 530-753-7662 - Yolokids

Filling out the Please FAX Completed Form To: 530-753-7662 - Yolokids is an important step in providing necessary information about your situation. This guide is designed to assist you in completing the form accurately and efficiently, ensuring your information is conveyed clearly.

Follow the steps to successfully complete the form.

1. Locate and select the ‘Get Form’ button to obtain the form and open it in your preferred editing platform.
2. Begin by filling out the mother's name, birthdate, address, zip code, and phone number in the designated spaces.
3. Next, provide the hospital name, father's name, and the father's birthdate in the corresponding fields.
4. Fill in the expected due date (EDD) and the baby's name along with the baby's date of birth (D.O.B.) and gender (M/F), including the baby's weight.
5. Indicate whether the family has other children by selecting 'Yes' or 'No.' If 'Yes,' enter the number of children in the designated area.
6. Complete the referral source section by entering the name of the individual or agency and their phone number.
7. Respond to the referral response request by checking 'Yes' or 'No'.
8. For first-time mothers, answer the statements with 'T' for true, 'F' for false, or 'U' for unknown, circling the appropriate marital status.
9. Circle the applicable health insurance option and provide details about preferred language and ethnicity.
10. Use the notes section to provide any additional relevant information.
11. Indicate any other reasons for referral by selecting the applicable options.
12. Ensure to enter your name, title, and the date in the 'Form Completed by' section.
13. Once all fields are filled, review the form for accuracy, then save the changes and prepare to share the completed form.

Complete your documents online today to ensure a smooth submission process.