Get Ne Dhhs Cred-0364 2013-2025

Filling out the NE DHHS CRED-0364 form online is a straightforward process that allows you to provide important information about your child and your family's contact details. This guide will take you through each step of completing the form to ensure that you include all necessary information accurately.

Follow the steps to complete the form successfully.

1. Press the ‘Get Form’ button to access the form and open it in your preferred online editor.
2. Begin by filling in your child's name and birthdate. Ensure this information is accurate, as it is essential for their records.
3. Next, provide the enrollment date and any updates regarding your child's attendance. Be sure to include the date care ceased if applicable.
4. Enter the home address of the parent or guardian along with their employment address. Fill in the details for both the father or guardian and the mother or guardian, including names, employers, addresses, and phone numbers.
5. Identify persons to whom the child may be released by the caregiver. Include names, addresses, cities, and phone numbers for each individual. If there are no individuals, write 'none' in the space provided.
6. List one or more persons who will take responsibility for your child in an emergency when you cannot be reached. Include names, addresses, cities, and phone numbers.
7. Provide your consent to contact the child's physician in an emergency. Fill in the caregiver’s name, the physician’s name, their phone number, and address.
8. Complete the medication competency statement by indicating who has determined that the child is competent to receive medication, signing, and dating where indicated.
9. Fill in the child's medical information, including current health status, any medications, allergies, intolerances, and special concerns. Clearly indicate any activities the child should not engage in.
10. Lastly, certify that the information provided is correct by signing the form and adding the date. After completing the form, you can save your changes, download the document, print it, or share it as needed.

Complete your documents online today to ensure your child's important information is accurately recorded.