Ocfs ldss 4433 form-2026

1. Click ‘Get Form’ to open the OCFS LDSS 4433 form in the editor.
2. Begin by entering the child's name and date of birth in the designated fields at the top of the form.
3. Fill in the date of examination, ensuring accuracy for record-keeping purposes.
4. Indicate whether immunizations are required for daycare entry by selecting 'Yes' or 'Medical Exemption'. If exempt, attach certification specifying exempt immunization(s).
5. Complete the immunization section by entering dates for each required vaccine, including MMR, Varicella, DPT, Polio, Hib, and Hepatitis B.
6. If applicable, provide details on any additional immunizations and tests such as Tuberculin Test and Lead Screening.
7. Address health specifics by indicating any allergies or medications taken regularly. Include comments if necessary.
8. Conclude with a summary of the physical exam findings and ensure that the examiner's signature, title, and contact information are filled out correctly.

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