Loading
Get Sc Dhec 1146 2024-2025
How it works
-
Open form follow the instructions
-
Easily sign the form with your finger
-
Send filled & signed form or save
How to fill out the SC DHEC 1146 online
The SC DHEC 1146 form is essential for documenting eligibility for the Vaccines for Children (VFC) program. This guide will walk you through each step of filling out the form online, ensuring clarity and compliance with the necessary requirements.
Follow the steps to complete the SC DHEC 1146 form online.
- Press the ‘Get Form’ button to access the SC DHEC 1146 online and open it for editing.
- Enter the child's name in the specified fields, including their last name, first name, and middle initial.
- Provide the child's date of birth by entering the day, month, and year in the designated format.
- Complete the section for the parent, guardian, or individual of record by filling in their last name, first name, and middle initial.
- Fill in the provider's name using the appropriate fields for the last name, first name, and middle initial.
- For each immunization visit, input the date and mark the eligibility category by selecting the appropriate columns A to D for VFC eligibility or E to G for non-VFC eligibility.
- Ensure all necessary fields are accurately filled out and review for any errors.
- Once completed, save the changes to the form. You can also download, print, or share it as needed.
Complete the SC DHEC 1146 form online to ensure proper immunization documentation.
Related links form
VFC eligibility is as follows: (a) Medicaid enrolled; (b) uninsured; (c) American Indian/Alaskan native; or (d) underinsured seen at an FQHC.
Industry-leading security and compliance
US Legal Forms protects your data by complying with industry-specific security standards.
-
In businnes since 199725+ years providing professional legal documents.
-
Accredited businessGuarantees that a business meets BBB accreditation standards in the US and Canada.
-
Secured by BraintreeValidated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.