Get Health Certificate For Child. Esa/whd Form Wh-347

Filling out the Health Certificate for Child (ESA/WHD Form WH-347) is a crucial step in ensuring your child's health information is properly documented for school or childcare requirements. This guide will provide you with clear, step-by-step instructions on how to complete the form accurately and efficiently online.

Follow the steps to fill out the form successfully.

1. Click ‘Get Form’ button to obtain the Health Certificate for Child (ESA/WHD Form WH-347) and open it in your preferred online editor.
2. In Part 1, provide the child's personal information. Fill out the child's last name, first and middle name, date of birth, gender, race/ethnicity, ward, home address, and contact numbers. Ensure accuracy to prevent any delays in processing.
3. Continue in Part 1 to enter the parent's or guardian's information. Include their name and select the type of telephone number (home, cell, or work). Also, specify the emergency contact person and their number.
4. Fill in the name of the school or childcare facility the child will be attending. Indicate whether the child is covered by Medicaid or private insurance. If the child has a primary care provider, include their information.
5. In Part 2, document the child's health history, including examination results and recommendations. Record the date of the health exam, weight, height, vision, and hearing screenings. Address any health concerns and provide details about allergies and medications.
6. In Part 3, assess the child's risk for tuberculosis and lead exposure. Document the results of the tuberculin skin test and lead test if applicable.
7. Move to Part 4 where the health provider certifies the child's health status. The provider must sign, print their name, and include their contact information.
8. In Part 5, obtain the signature of the parent or guardian. This section authorizes sharing the child's health information with relevant agencies.
9. Once all sections are filled accurately, save changes to the form. Users can then download, print, or share the completed form as needed.

Complete your Health Certificate for Child (ESA/WHD Form WH-347) online today to ensure your child's health documentation is ready for school or childcare.