Get Ssa-3376-bk 1995

Completing the SSA-3376-BK form is essential for providing information regarding a child's functional capabilities and limitations. This guide offers a step-by-step approach to ensure users can accurately and effectively fill out the form online.

Follow the steps to successfully complete the SSA-3376-BK form online.

1. Press the ‘Get Form’ button to obtain the form and access it in the online editor.
2. In Section 1, provide identifying information. Fill in the child's name, Social Security number, date of birth, your name, relationship to the child, the date you completed the form, your daytime telephone number, and mailing address.
3. Move to Section 2, which contains function details. For each question regarding the child’s abilities (sight, hearing, speech, understanding, physical abilities, behavior with others, and personal care), choose 'Yes' or 'No' as appropriate. If 'Yes', provide additional explanations as needed.
4. Use the remarks section to elaborate on any aspect if the space provided in the previous questions was insufficient. Specify the question number for reference.
5. Review all sections for accuracy and completeness. Ensure that you have included all necessary details and responses.
6. Once completed, save changes to the document. You may also download, print, or share the form as necessary.

Start filling out the SSA-3376-BK form online today to assist in the disability decision-making process.