DHHS: DPH: Women's and Children's Health Section - NC 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering participant information, including Last Name, First Name, Middle Initial, Date of Birth, and Race. Ensure accuracy as this data is crucial for identification.
3. Fill in the Ethnic Origin and County of Residence fields. If there are any changes to the address, check the appropriate box.
4. Complete the Contact Type section by selecting how you will be contacted (Phone, Home Visit, Office).
5. Indicate if the participant is enrolled in another program. This helps avoid duplication of services.
6. Proceed to fill out sections regarding health insurance, education level, employment status, and transportation needs.
7. Answer questions related to postpartum care and breastfeeding practices. This information is vital for health assessments.
8. Finally, review all entries for completeness and accuracy before submitting the form through our platform.

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