Lic 503 2025

Show details

4.8 out of 5

86 votes

The document is a Health Screening Report required by the California Department of Social Services for personnel working in Residential Care Facilities, Community Care, or Child Care Facilities. It mandates that all staff demonstrate their health suitability for their roles through a health appraisal conducted by a physician, which must be completed within one year prior to employment or within seven days after. The report includes sections for personal information, types of individuals served, and medical evaluations to ensure staff are free from communicable diseases and capable of performing their duties.

Here's how it works

01. Edit your lic 503 form online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send lic 503 via email, link, or fax. You can also download it, export it or print it out.

The best way to change Lic 503 online

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

With DocHub, making adjustments to your documentation takes only some simple clicks. Follow these quick steps to change the PDF Lic 503 online for free:

Register and log in to your account. Sign in to the editor with your credentials or click Create free account to evaluate the tool’s capabilities.
Add the Lic 503 for redacting. Click on the New Document option above, then drag and drop the file to the upload area, import it from the cloud, or using a link.
Change your file. Make any adjustments required: insert text and images to your Lic 503, highlight important details, remove sections of content and substitute them with new ones, and add icons, checkmarks, and fields for filling out.
Finish redacting the template. Save the updated document on your device, export it to the cloud, print it right from the editor, or share it with all the people involved.

Our editor is super easy to use and efficient. Try it now!

See more lic 503 versions

We've got more versions of the lic 503 form. Select the right lic 503 version from the list and start editing it straight away!

Versions	Form popularity	Fillable & printable
1999	4.8 Satisfied (86 Votes)

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is the lic form?

LIC Full Form. Life Insurance Corporation of India (LIC) is an Indian judicial, allowance, and endowment corporation, centralised in Mumbai, India, concealed by proprietorship of the Ministry of Finance of India. Life India Corporation of India (LIC) was created on the first September 1956.

What is the lic 500 form?

Form 602 is issued by the California Department of Social Services. The form was established as a way to help senior communities better understand the needs of potential residents in terms of medical assistance, nutritional needs, mental and physical capabilities and other care requirements.

What is the form of LIC death claim?

Death Claims: Claim Form A in Form No.3783. If policy has run for 3 years or more from date or risk, claim form no.3783A may be used. Certified extract from death register. The original policy document with Deed/s of assignment/s, if any.

What is a LIC 508 form?

CRIMINAL RECORD STATEMENT OUT-OF-STATE DISCLOSURE. LIC 508 (7/21) Page 1 of 5 State law requires that persons associated with licensed care facilities, Home Care Aide Registry or TrustLine Registry applicants be fingerprinted and disclose any conviction.

What is the lic 503 form?

The LIC 503 is required by the California Department of Social Services as part of the application process to work in a Community Care facility. It is used during the hiring process to verify the health of the applicant. It requires completion and signature by a physician.

lic503

LIC 503 PDF LIC 501 LIC 503 6 24 LIC 503 instructions Lic 503 2025 Lic 503 spanish Lic 503 health SCREENING Lic 503 cdss

How to fill out a health screening report?

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES. PERSONNEL REPORT. INSTRUCTIONS: This form is intended for keeping a current roster of all the facility personnel, other adults and licensees residing in the facility, including backup persons, volunteers and licensee if administrator/director.

How to fill out lic 500?

How to fill out CA LIC 500 Obtain the CA LIC 500 form from the California Department of Insurance website or a local office. Fill in the applicants full legal name in the designated section. Provide the applicants mailing address, including city, state, and zip code.