Get Nc Dhhs 3987 2010

This guide provides clear and supportive instructions for completing the NC DHHS 3987 form online. By following these steps, users will be able to accurately document medical exemptions for immunizations with confidence.

Follow the steps to complete the NC DHHS 3987 online

1. Use the ‘Get Form’ button to access the NC DHHS 3987 and open it in your preferred editor.
2. Begin by filling out the patient information section. Enter the patient's name, date of birth (DOB), and address. Additionally, include the name and address of the parent or guardian.
3. Indicate the school or child care program the patient attends, ensuring that this information is accurate.
4. In the section regarding true contraindications and precautions, carefully review the vaccines listed. For each vaccine, check any applicable contraindications or precautions that apply to the patient.
5. Specify the date that the medical exemption is set to end. This information is critical for maintaining accurate medical records.
6. Complete the physician's section by printing the name of the North Carolina physician who is verifying the exemption.
7. Attach a copy of the most recent immunization record to the form. This is necessary for validation of the exemption.
8. Before submitting, retain a copy of the completed form for your records.
9. Return the original signed document to the individual or organization that requested it.

Complete your NC DHHS 3987 online today to ensure your patient's medical exemptions are accurately documented.