Get Dss Form 3082 (jan 17) Dss Form 3082 (oct 06).qxd - Dss Sc

Filling out the DSS Form 3082 is an important step in ensuring the health and safety of infants left at safe havens. This guide provides clear instructions on how to accurately complete the form, ensuring that all necessary information is recorded appropriately.

Follow the steps to successfully complete the form online.

1. Use the ‘Get Form’ button to obtain the form and access it in the online editor.
2. In Section I, enter the infant's name, date of birth, sex, race, and provide a physical description of the person leaving the infant. Also include the date and time the infant was left, as well as the name and address of the safe haven.
3. Moving to Section II, fill in the mother’s and father’s names, dates of birth or ages, addresses, and physical descriptions. Ensure all information is as complete as possible.
4. In Section III, record any relevant medical history of the parents, including substance use during pregnancy, prenatal care, and any known health issues, such as HIV status or mental health conditions.
5. In Section IV, document the circumstances surrounding the abandonment of the infant. Include details such as the location of birth if known.
6. Section V requires information about the receipt of the infant by the hospital. Fill in the name of the hospital staff receiving the infant, their phone number, the name of the hospital, and the date and time the infant was received.
7. Review all completed sections of the form for accuracy. Once confirmed, you can save changes, download, print, or share the form as needed.

Ensure the safety and well-being of infants by completing the necessary documents online.