Get Form K 905 2403

Filling out the Form K 905 2403 online can streamline the process of documenting medical appointments for children and youth. This guide provides step-by-step instructions to help you complete the form accurately and efficiently.

Follow the steps to complete the Form K 905 2403 online.

1. Select the ‘Get Form’ button to retrieve the form and access it in an editor.
2. Begin with Section I, where you will provide the child's information. Enter the child's name, date of birth, Person Identification Number, and appointment date.
3. Next, complete the caregiver information section. This includes the caregiver's name, address, phone number, agency, city, state, and zip code.
4. Fill in the caseworker information by entering the caseworker's name, phone number, and fax number.
5. Specify the reason for the visit by checking the appropriate options, such as '3-Day Medical Exam' or 'Routine Texas Health Steps Medical Checkup', and provide any additional details as necessary.
6. If applicable, complete the medications section by indicating whether the child takes medications. List any medications along with dosage, prescribed for, and caregiver comments.
7. Sign Section I at the designated spot to indicate completion of that section and enter the date signed.
8. In Section II, if the health care provider is completing the form, ensure they fill in the child's name, date of birth, and appointment date. If they are unable to complete the section, provide the caregiver's signature and date in the designated area.
9. After all sections of the form are filled out, you can save changes, download, print, or share the completed form as needed.

Begin filling out your Form K 905 2403 online today for efficient documentation of medical appointments.