Get Staff Health Report - Child Care Provider, Dcf-f (cfs-0054). Becr Fill-able Internet Form - Nwtc

This guide provides a clear and supportive overview of how to correctly complete the Staff Health Report - Child Care Provider, DCF-F (CFS-0054). Understanding each section will ensure your report is filled out accurately and complies with all requirements.

Follow the steps to accurately fill out the Staff Health Report.

1. Press the ‘Get Form’ button to access the Staff Health Report form, and open it in your online editor.
2. Begin by filling out Section A, which includes your personal information as the child care provider. Provide your last name, first name, and middle initial, followed by your position title.
3. Move to Section B, where you will need to document the tuberculosis test results. Indicate the type of test administered (Mantoux Tuberculin Skin Test or QuantiFERON Blood Assay), enter the date of the test, and select the outcome from the options provided—Positive or Negative.
4. Indicate the risk classification based on the results of the tuberculosis test, choosing between low risk or medium risk. If the result was positive, you must also detail the outcomes of any follow-up medical evaluation.
5. Complete the health professional signature area, which includes the signature of the examining health professional, their office address, and the name printed or typed.
6. Proceed to Section C. Here, you will state whether a chest X-ray was completed and provide additional details regarding induration measurements, selecting from 5mm, 10mm, or 15mm.
7. Sign and complete the physical exam certification. The health professional must verify that the individual appears free of communicable diseases and is physically able to work with children.
8. After reviewing all entries for accuracy, finalize the document by saving changes, downloading, printing, or sharing the form as needed.

Complete your Staff Health Report online today to ensure compliance and proper documentation.