Dhs illinois 2025

1. Click ‘Get Form’ to open the dhs illinois document in the editor.
2. Begin by filling in the 'Case Name' section with the last, first, and middle names of the child. Ensure clarity for accurate processing.
3. Enter the 'Case Number' provided by your agency to track this record effectively.
4. Complete the 'Name of Hospital' and 'Hospital's Address' fields, including street, city, state, and zip code for proper identification.
5. Fill in the baby's full name and date of birth. Indicate the sex and check any applicable boxes regarding adoption or death.
6. Provide mother's full name, social security number, birthdate, recipient number, phone number, and address details.
7. Input father's full name, social security number, birthdate, and address information as required.
8. Designate a hospital contact person by printing their name and providing their phone number for follow-up communication.
9. Finally, ensure an authorized hospital staff member signs and dates the form before submission.

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