How to use or fill out dhec 1123 form with our platform
- Click ‘Get Form’ to open the dhec 1123 form in the editor.
- In SECTION I - PUPIL INFORMATION, enter the pupil's last name, first name, and middle initial. Fill in the parent's name, complete address including zip code, and telephone number.
- Move to SECTION II - IMPORTANT INFORMATION FOR SCHOOL OFFICIALS. This section is informational; no entries are required here.
- In SECTION III - SCHOOL OFFICIAL'S CERTIFICATION OF SPECIAL EXEMPTION, check the appropriate box for either transfer or non-transfer student based on the situation.
- Have the school official sign in the designated area and enter their telephone number along with the date the certificate is issued.
- Ensure that a copy of this certificate is filed at the school and sent to the local health department as required.
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| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2005 | 4.2 Satisfied (38 Votes) |
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