Get Medical Certification For Tanf And Ga - Delaware Health And Social ...

Filling out the Medical Certification for TANF and GA is an important step for individuals seeking assistance based on medical incapacity. This guide provides clear instructions to help you complete the form accurately and effectively online.

Follow the steps to successfully fill out the form.

1. Press the ‘Get Form’ button to access the form in your preferred document editor.
2. Begin by entering the requestor's name and address at the designated fields at the top of the form.
3. In the 'Major Complaint' section, clearly describe the main medical issue affecting the person applying for assistance.
4. Fill in the 'Usual Occupation' section to indicate the job the applicant typically holds, followed by the date of completion.
5. In the 'Date of Examination' field, provide the date when the medical evaluation took place and input the corresponding diagnosis.
6. If applicable, include information regarding the pregnancy, such as the expected date of delivery and gestational age in the appropriate sections.
7. Answer the subsequent questions regarding the applicant's ability to care for their children and work in their usual occupation by selecting the appropriate options.
8. Indicate the estimated duration of any illness affecting the patient by checking one of the options provided.
9. Determine if additional care is needed at home for the patient by answering the relevant question.
10. If there are any additional remarks, make sure to write them in the 'Remarks' section provided.
11. After completing the form, ensure that the medical professional signs and dates it. Include their printed name, address, and telephone number.
12. Lastly, obtain the patient's signature along with the date to validate the form.
13. Once all fields are completed, you can save, download, print, or share the form as needed.

Complete the Medical Certification form online to ensure a smooth application process for assistance.