Get Function Report - Child Age 1 To 3rd Birthday. Use This Form To Complete A Function Report For A

This guide provides clear instructions for filling out the Function Report - Child Age 1 to 3rd Birthday. By following these steps, you will be able to effectively provide the necessary information about the child’s functioning to support their claim.

Follow the steps to complete the form accurately.

1. Click ‘Get Form’ button to obtain the form and open it in your preferred document editor.
2. In Section 1, enter the child’s identifying information, including their name, social security number, date of birth, and your relationship to the child. Be sure to provide the date the form is completed, along with your daytime telephone number and mailing address.
3. In Section 2, proceed to the function details. Start with question 2.A regarding the child's vision. Mark all applicable statements if the child has issues with seeing, otherwise proceed to question 2.B.
4. For question 2.B regarding the child’s hearing, follow the same procedure. Indicate if the child uses hearing aids or has other hearing problems, and continue to question 2.C.
5. In question 2.C, you will assess the child’s ability to speak. Indicate if they can say simple words or phrases and note any significant speech-related challenges.
6. Continue to question 2.D to evaluate the child’s learning capabilities and understanding. Check the appropriate boxes for their responses and provide any necessary explanations.
7. In question 2.E, assess the child’s physical abilities. Document their mobility skills and any limitations they may have. Proceed to question 2.F regarding their behavior with others.
8. For question 2.G, review the child’s ability to perform personal care tasks. Highlight their independence with activities like dressing or feeding.
9. In Section 3, use the remarks section to provide any additional information relevant to the child’s condition or functioning that may help in their assessment.
10. Finally, save your changes, and download or print the document if needed for submission.

Complete the Function Report online to ensure timely processing of the child's claim.