
Get Tn Hs-0120 2009-2025
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How to fill out the TN HS-0120 online
Filling out the TN HS-0120 form, also known as the Child Care Provider Medical Report, is a crucial step in the licensing process for child care providers in Tennessee. This guide provides clear instructions to assist users in completing the form accurately and efficiently online.
Follow the steps to complete the TN HS-0120 form online.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Begin by entering the provider's name, birth date, and address in the designated fields. Ensure that all information is accurate and up-to-date.
- In the authorization section, the provider must sign their name to authorize the physician to release information to the Department of Human Services.
- List the name(s) of the physician(s) who will be completing the medical evaluation form and the purpose of the examination, which may include initial employment or re-examination.
- Indicate the types of activities in child care that apply to the provider by checking all relevant boxes, including caregiver, food preparation, driver, or facility maintenance.
- The physician must answer the medical history questions. This includes their familiarity with the patient and evaluating the patient's physical capabilities related to child care.
- If the physician notes any physical, mental, or emotional limitations, they should specify these in the designated area provided in the form.
- The physician should also check if the patient is currently taking any medications that could affect their work role and provide explanations where necessary.
- After all fields are filled in, the physician should sign the document, date it, and provide their additional comments, if any.
- Once all the information is completed, choose to save changes, download, print, or share the form as required.
Complete your document online today to ensure a smooth certification process!
Related links form
You can look up daycare violations in Tennessee online by accessing the state's licensing database. This database provides detailed information on any reported violations and compliance status according to TN HS-0120. Reviewing this information helps you make informed decisions about your childcare options.
Fill TN HS-0120
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