Dss form w 303a 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin with Part A, where you will provide your personal information such as your name, DSS Client ID, address, and date of birth. Ensure all fields are filled accurately.
3. Move to Part B to describe your health issues. List any doctors or clinics treating you and provide details about your health problems. Attach additional sheets if necessary.
4. In Part C, assess your capabilities by checking the appropriate boxes for activities you can perform. This section helps illustrate how your health affects daily tasks.
5. Complete Part D by detailing your education and training history. Indicate if you were in special education or vocational training programs.
6. Finally, in Part E, summarize your work history over the last 15 years. Include job titles, types of businesses, and dates worked.
7. Don’t forget to sign and date the form before submitting it back to your DSS worker.

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