Get Staff Health Report 2020-2025

Filling out the Staff Health Report is an essential process for ensuring the health and safety of all staff members working in religiously exempt child day centers. This guide provides step-by-step instructions to help you complete the form online with ease.

Follow the steps to successfully complete the Staff Health Report.

1. Click the ‘Get Form’ button to obtain the Staff Health Report and open it in your chosen editor.
2. In the top portion of the form, enter the name of the religious institution. This information identifies where the staff member is employed.
3. Next, enter the name of the staff member. Ensure that the name matches the identification documents for accuracy.
4. The staff member should provide a copy of this form to their examining physician or licensed health practitioner. This initiates the completion of the medical portion of the report.
5. The bottom portion of the form must be filled out and signed by the physician, physician's assistant, or licensed nurse practitioner. Note that signatures from an R.N. or L.P.N. are not acceptable.
6. The physician or nurse practitioner should certify that the staff member is free from any disability that would prevent them from caring for children.
7. The physician or nurse practitioner must sign and print their name, along with the date of examination and their address. This will complete the medical verification required.
8. Once the form is fully completed, ensure all necessary signatures and information are present before saving, downloading, printing, or sharing the form as needed.

Complete your Staff Health Report online today to ensure compliance and maintain the health standards of your facility.