Get Chronic Illness Verification Form - Child Welfare & Attendance (ca Dept Of Education). The

The Chronic Illness Verification Form is an essential document that allows parents to formally excuse their child's absences due to specific medical conditions. This guide will provide clear, step-by-step instructions on how to accurately complete this form, ensuring compliance with school district policies.

Follow the steps to accurately complete the chronic illness verification form.

1. Click ‘Get Form’ button to obtain the form and open it for online completion.
2. Begin by filling in the student’s name, date of birth, and grade in the appropriate fields. Ensure all information is accurate and up-to-date.
3. Provide the school’s name and fax number where the completed form will be sent. This information is essential for effective communication.
4. Instruct the physician to list the diagnosed chronic illness of the student and check or list any symptoms that may not require an office visit but justify staying home from school.
5. Complete the fields for expected frequency of episodes and length of absences per episode, specifying details like monthly occurrences or other time frames.
6. Ensure the physician’s signature, printed name, and address are included. Attach the physician’s business card to authenticate the document.
7. As a parent/guardian, sign the authorization section, confirming agreement to share information related to the child's diagnosis between the school and the physician.
8. Date the authorization signature and indicate if you wish to be informed prior to the school contacting the physician regarding absences.
9. Review all entries for clarity and accuracy before finalizing. Save your changes, then download, print, or share the completed form as needed.

Complete your Chronic Illness Verification Form online now to ensure your child’s medical condition is appropriately documented.