Dh 3040 form pdf

    • [PDF File]STATE OF FLORIDA Page 1 of 2 School Entry Health Exam

      https://info.5y1.org/dh-3040-form-pdf_1_e0bc79.html

      the health care provider. The original completed DH 3040 Form should be given to the parent to take to the school to provide information and to document that this requirement is met. Directions for completing the School Entry Health Exam Form Page 1: The health history is to be filled in by the parent or interviewer in the provider’s office ...

    • [PDF File]Page 1 of 2 STATE OF FLORIDA School Entry Health Exam

      https://info.5y1.org/dh-3040-form-pdf_1_be81ae.html

      STATE OF FLORIDA School Entry Health Exam To Parent/Guardian: Please complete and sign Part I — Child’s Medical History. State law for school entry requires a health examination by …

    • [PDF File]Florida Shots™ Creating a DH Form 680 And Parent Pin

      https://info.5y1.org/dh-3040-form-pdf_1_878960.html

      2018-03-05 · – This button will create a PDF version of the Certified Form 680 which can be printed directly onto white paper, as the Department of Health watermark is visible on the PDF document, making it a legal and valid form. If the parent should lose the Information Sheet you …

    • [PDF File]SCHOOL ENROLLMENT AND REGISTRATION

      https://info.5y1.org/dh-3040-form-pdf_1_7aad0a.html

      immunization records – “blue card” form DH 680 (a maximum of 30 school days is allowed to present proof of immunization) Social Security card (requested but not required) physical examination given by a Florida physician submitted on a DH 3040 form

    • [PDF File]Florida Department of Health

      https://info.5y1.org/dh-3040-form-pdf_1_8d0c8b.html

      Florida Department of Health Completing the School Entry Health Exam Form (DH3040-CHP-07/2013) General Information Purpose: The School Entry Health Exam has been designed to meet the requirements for the school entry health examination, as mandated by s.1003.22, F.S., for student entry into Florida public and

    • [PDF File]Guide for Student Entry Health Exam 7-02

      https://info.5y1.org/dh-3040-form-pdf_1_af22e2.html

      the health care provider. The original completed DH 3040 Form should be given to the parent to take to the school to provide information and to document that this requirement is met. Directions for completing the School Entry Health Exam Form Page 1: The health history is to be filled in by the parent or interviewer in the provider’s office ...

    • [PDF File]DH Form 3040 Q&A

      https://info.5y1.org/dh-3040-form-pdf_1_44758c.html

      DH Form 3040 Questions & Answers . Answer: The School Health Physical Exam Form, DH 3040, was developed as the school entry physical exam record. It is color coded for ease in retrieving the form from the child's Student Cumulative Record. Historically, it has been the School Health Office position that the

    • [PDF File]STATE OF FLORIDA School Entry Health Exam

      https://info.5y1.org/dh-3040-form-pdf_1_81d1e8.html

      STATE OF FLORIDA School Entry Health Exam. Page 1 of 2. To Parent/Guardian: Please complete and sign Part I — Child’s Medical History. State law for school entry requires a health examination by a legally qualified professional.

    • [PDF File]Florida School Entry Health Requirements

      https://info.5y1.org/dh-3040-form-pdf_1_423979.html

      Florida School Entry Health Requirements School Entry Health Examination (School Physical) Form DH 3040 (Physical exam must have been performed within 12 months prior to registration) Florida Certificate of Immunization (Immunization Record) Form DH 680 (Must be used to document immunizations required for entry and attendance in Florida

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