Get Baby Alert System Form Fy 2012 - State Of New Jersey - State Nj

Filling out the Baby Alert System Form FY 2012 online is a straightforward process that enables parents or guardians with hearing loss to request vital equipment. This guide provides step-by-step instructions to assist you in completing the form efficiently and accurately.

Follow the steps to fill out the Baby Alert System Form online.

1. Click ‘Get Form’ button to access the Baby Alert System Form. Once you have the form, open it in your editor of choice.
2. Begin by filling in your last name in the designated field marked 'Parent/Guardian Last Name.' Ensure that you print clearly to avoid any mistakes.
3. In the 'First Name' field, provide your first name, again printing clearly.
4. Fill in your street address in the 'Street Address' section. Note that the address cannot be a PO Box.
5. Enter your city of residence in the corresponding field and state abbreviation in the 'State' box.
6. Complete the 'Zip Code' field with your area’s postal code.
7. Input your home phone number in the designated space.
8. Provide your email address or fax number for communication purposes in the following field.
9. Enter your baby's name in the 'Baby’s Name' field.
10. Specify your baby’s date of birth using the format 'Mo/Day/Year.'
11. You must either attach an audiogram or written report from a licensed audiologist confirming your hearing loss, or obtain the signature of a licensed audiologist or physician in the designated area.
12. Sign the application to attest to the accuracy of the provided information and confirm that you meet the eligibility requirements.
13. After completing all sections of the form, you can save your changes. You may also download, print, or share the form as needed.

Complete your Baby Alert System Form online today and ensure you receive the support you need.