Get Mi Bcal-3704-cc 2019-2025

Filling out the MI BCAL-3704-CC form is a crucial step for individuals applying for child care licensing in Michigan. This guide provides you with a clear and supportive approach to complete the form accurately and efficiently.

Follow the steps to ensure correct completion of the form.

1. Click the ‘Get Form’ button to access the MI BCAL-3704-CC form, allowing you to open it in your preferred document editor.
2. Begin by filling out the applicant/licensee information section. Enter the facility or home name, license number, and the complete facility address including street number and name, city, state, and zip code.
3. Provide the name, address, and phone number of the licensing consultant to whom the completed form should be mailed.
4. Next, move to the patient information section. The patient must print or type their name, date of birth, telephone number, and address, including street number and name, city, state, and zip code.
5. In the release of information section, the patient must date and authorize the release of medical information. They should sign where indicated, and the physician’s name must be printed or typed.
6. Now, the medical information section needs to be completed by the physician. Answer the questions about the patient's tuberculosis testing, detailing the test type, date, and results.
7. Provide a description of the patient's physical and mental condition regarding their ability to care for children. Use the comments section for any necessary explanations.
8. If applicable, indicate whether the physician would like to be contacted by the licensing consultant and sign and date the section provided.
9. Finally, review all entries for accuracy and completeness. Once verified, you can save the form, download it, print, or share it as required.

Ensure your child care licensing process is seamless by completing the MI BCAL-3704-CC form online today.