
Department of Health and Human ServicesWaiver of Physical Examination/Visual Evaluation Requirement School Name (if desired)Note to Parent/Guardian: please complete and return to the school health.
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How to fill out the NE FH-40 (44040) online
This guide provides clear instructions on how to fill out the NE FH-40 (44040) form online, designed for individuals seeking a waiver of physical examination and visual evaluation for school entry in Nebraska. By following these steps, you will be able to complete the form efficiently and accurately.
Follow the steps to complete the NE FH-40 (44040) form online.
- Click ‘Get Form’ button to obtain the form and open it in the online editor.
- Begin by filling in your child's information. Provide the student name, student ID number, school name, and grade in the designated fields.
- Indicate which requirements you wish to waive by checking the appropriate boxes for physical examination and/or visual evaluation. Ensure that you only check the boxes that apply to your situation.
- Read the statement regarding the ability to request information about reduced-cost vision examinations, and confirm your understanding of the waiver provisions.
- Sign the form in the signature field designated for the parent or guardian, ensuring that your signature is clear and legible.
- Enter the date when you are filling out the form in the space provided.
- Use the comments section to add any additional remarks or notes that you wish to include.
- After reviewing all entries for accuracy, save your changes, and choose to download, print, or share the completed form as needed.
Complete the NE FH-40 (44040) form online today to ensure your child meets school entry requirements easily.
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