Dhs forms for child care 2026

1. Click ‘Get Form’ to open the Child Care Provider Physical Examination Report in the editor.
2. Begin by entering the provider's name and the date of examination at the top of the form.
3. In the 'Patient may' section, review and check all applicable boxes that describe the provider's responsibilities and physical capabilities.
4. Move to the 'Child Care Provider Health Concerns' section. Carefully check all health concerns that apply to ensure a comprehensive overview of the provider's health status.
5. Fill out the immunization status by having a physician review and check off whether the patient is current with ACIP recommended immunizations.
6. Complete the Tuberculosis Screening section by ensuring both components are checked and dated by a physician.
7. Answer questions regarding communicable diseases and overall health status, providing detailed descriptions where necessary.
8. Finally, have the healthcare provider sign, date, and provide their contact information at the bottom of the form.

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