Form 3040 florida
[PDF File]STATE OF FLORIDA Page 1 of 2 School Entry Health Exam
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DH 3040, 6/02 (Obsoletes previous editions which may not be used) Stock Number: 5744-000-3040-2 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]DH Form 3040 Q&A
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t DH Form 3040 Questions & Answers The Basic Facts: Florida Statute 1003.22(1), and Chapter 6A-6.024, Florida Administrative Code, outlines the basic DOE …
[PDF File]Florida School Entry Health Requirements
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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
[PDF File]Florida Immunization Requirements: FAQs
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records. Their office can provide you with your child’s Florida Certification of Immunization (DH Form 680), the form needed for school. Another place to look is at the County Health Department (CHD). If you received any immunizations there, they may be able to provide you with an immunization history.
[PDF File]2019 School and Sports Physicals Resource Guide CRESTVIEW
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Form 3040 for School Physical. Form EL2 for Athletic physical. *Has a Crestview location Emerald Waters Medical Clinic 1005 West College Boulevard, B, Niceville, FL 32578 (850) 279-6815 $45 $35 Appointmen t required Yes. *Patients 12 years and older only. *Medicaid - only taking Humana CVS Minute Clinic 4562 E Hwy 20 Niceville, FL 32578
[PDF File]Page 1 of 2 STATE OF FLORIDA School Entry Health Exam
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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 Department of Health
https://info.5y1.org/form-3040-florida_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]STATE OF FLORIDA Page 1 of 2 School Entry Health Exam
https://info.5y1.org/form-3040-florida_1_ea4e35.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]State of Florida
https://info.5y1.org/form-3040-florida_1_245c40.html
(Form 3040) and immunization record (Form 680 or 681) within 30 days of enrollment. • Section 7.3, of the Child Care Facility Handbook, requires that parents receive a copy of the Child Care Facility Brochure, "Know Your Child Care Facility” (CF/PI 175-24), or
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