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Get Ca Cdph 247 2014-2026
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How to fill out the CA CDPH 247 online
The CA CDPH 247 form is essential for healthcare providers to refer pregnant and postpartum women to the WIC program. This guide provides a step-by-step approach to successfully complete the form online while ensuring all necessary details are accurately captured.
Follow the steps to effectively complete the CA CDPH 247 form.
- Press the ‘Get Form’ button to access the CA CDPH 247 form and load it into your online interface.
- Fill in the patient's name in the specified format: last name followed by first name.
- Input the patient’s address, ensuring you include the street, city, and ZIP code.
- Provide the patient's telephone number for contact purposes.
- Record the woman’s current height and weight, along with the measurement date.
- Enter the woman's hemoglobin and hematocrit levels, as well as the dates for the relevant blood tests.
- Indicate any medical conditions affecting the woman by checking the appropriate boxes.
- List any medications or supplements that have been prescribed to the woman.
- Document any significant pregnancy outcomes, including delivery details and the health of the infant(s).
- Complete sections regarding previous pregnancies and any remarks or comments vital for counseling.
- Fill in the name of the healthcare provider, group, or clinic, along with their contact number.
- Sign and date the form to validate it as the health care provider before submission.
- Once all information is accurately entered, save your changes, then choose to download, print, or share the completed form as needed.
Complete the CA CDPH 247 form online to ensure timely assistance through the WIC program.
In California, WIC benefits can last up to one year for eligible participants. After the initial benefit period, you will need to reapply and demonstrate continued eligibility. The CA CDPH 247 offers detailed resources to help you understand the reapplication process. Staying proactive will help you continue receiving vital nutritional assistance.
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