Form preview picture

Get CA CDPH 247A 2016-2021

ID#: SECTION I: omplete this section to assist the patient with WIC eligibility, WIC services, and appropriate referrals. Whenever a therapeutic formula is prescribed, complete both Sections I and II. PATIENT NAME: (First) CURRENT HEIGHT/LENGTH: (within 60 days) (Last) CURRENT WEIGHT: (within 60 days) lbs inches oz DATE OF BIRTH: CURRENT BMI: (within 60 days) BMI percentile: MEASUREMENT DATE: lbs % HEMOGLOBIN OR HEMATOCRIT TEST is required every 12 months when normal LEAD TEST.

How It Works

wicworks rating
47 votes

How to fill out and sign Dysphagia online?

Get your online template and fill it in using progressive features. Enjoy smart fillable fields and interactivity. Follow the simple instructions below:

Experience all the advantages of completing and submitting forms online. Using our solution filling in CA CDPH 247A usually takes a matter of minutes. We make that possible by offering you access to our feature-rich editor capable of altering/correcting a document?s initial text, adding unique fields, and putting your signature on.

Execute CA CDPH 247A in a few clicks following the guidelines below:

  1. Select the document template you need in the library of legal forms.
  2. Select the Get form button to open the document and begin editing.
  3. Fill out the requested boxes (these are yellow-colored).
  4. The Signature Wizard will help you put your e-autograph after you have finished imputing data.
  5. Insert the date.
  6. Check the whole document to ensure you have filled in everything and no corrections are required.
  7. Press Done and download the resulting form to the gadget.

Send the new CA CDPH 247A in a digital form right after you are done with filling it out. Your data is well-protected, as we keep to the latest security requirements. Join numerous happy users that are already completing legal forms straight from their homes.

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.

Video instructions and help with filling out and completing GERD

Take advantage of our instructional video tutorial for filling out and submitting Form using our online editor. Start now so you can unwind later.

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.

Ensure the security of your data and transactions

USLegal fulfills industry-leading security and compliance standards.

  • VeriSign logo picture

    VeriSign secured

    #1 Internet-trusted security seal. Ensures that a website is free of malware attacks.

  • Norton logo picture

    Norton Secured

    The highest level of recognition among eCommerce customers.

  • Accredited Business

    Guarantees that a business meets BBB accreditation standards in the US and Canada.

  • TopTenReviews logo picture

    TopTen Reviews

    Highest customer reviews on one of the most highly-trusted product review platforms.