Florida health form dh 3040

    • [PDF File]H. Health Examination DH Form (3040) prior to examination ...

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      into a Florida school. Parents/legal guardians of all students (PK-12) must present tangible evidence of a health examination complete with Tuberculosis Clinical Screening and follow-up on the appropriate DH Form (3040) prior to initial entrance into a Miami-Dade County Public School. The health

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    • [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

      florida physical form dh 3040

    • School Entry Health Requirements

      School Entry Health Examination (School Physical) Form DH 3040 (Physical Examination dated 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 Schools)

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    • [PDF File]DH Form 3040 Questions & Answers

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      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

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    • [PDF File]Florida Department of Health

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      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

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    • [PDF File]Record Keeping - Florida Department of Health in Pinellas

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      The physical examination must be recorded on HRS-H Form 3040, Student Health Examination. This document is valid for two (2) years from the date the physical was performed. Immunization Certificate The immunizations must be recorded on DH Form 680, parts A-1, B, and/or C, or DH Form 681, Florida Certificate of Immunizations.

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

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      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.

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    • [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 …

      form dh 3040

    • [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 a legally qualified professional. Additional requirements may be determined ... I give permission for the information on PARTS I and II of this form

      florida physical form dh 3040

    • [PDF File]STATE OF FLORIDA 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 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.

      dh 3040 form pdf

    • [PDF File]IMPORTANT INFORMATION

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      Examination Form DH 3040 is the acceptable form and is in circulation in physician’s offices and the county health units. If a student presents a physical examination report performed in the last 12 months that is similar to the DH 3040 form with much of the same health information included, that form can be accepted.

      dh 3040 physical form pdf

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

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      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.

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    • [PDF File]School Health Entry Exam Form - Florida Department of Health

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      This child has a health condition that may require emergency action at school, e.g. seizures, allergies. Specify below. (This form will be stored in the child’s Cumulative Health Folder and may be accessed by both school and health personnel.) Recommendations (Attach additional sheet if necessary): (Please Check One)

      form 3040 florida

    • [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 a legally qualified professional. Additional requirements may be determined ... I give permission for the information on PARTS I and II of this form

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    • [PDF File]Florida School Entry Health Requirements

      https://info.5y1.org/florida-health-form-dh-3040_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

      form dh 3040 florida

    • [PDF File]Legend: Body Mass Index (BMI CFR) FAC FERPA SHARM Resource ...

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      School Entry Health Exam (Form DH 3040 or equivalent) present, unless documented as exempt pursuant to Florida statute and/or administrative code. Ch. 64F -6.005 FAC : Documentation of health history, chronic conditions, treatment plans, nursing assessments, IHPs , health counseling, consultations, recommendations , referrals and f ollow-ups

      form dh 3040

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

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      Guide for Completing the School Entry Health Exam (DH 3040 Form) DH 3040, 6/02, Stock Number: 5744-000-3040-2 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. (formerly s. 232.0315, F.S.) for student entry into Florida

      florida physical form dh 3040

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

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      Guide for Completing the School Entry Health Exam (DH 3040 Form) DH 3040, 6/02, Stock Number: 5744-000-3040-2 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. (formerly s. 232.0315, F.S.) for student entry into Florida

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    • [PDF File]HEALTH AND IMMUNIZATION REQUIREMENTS

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      The school entry health exam should be completed on the State of Florida School Entry Health Exam form (DH-3040). When using this form, parents/guardians must complete page one (1). A health care provider may complete page two (2) or submit their own documentation of the medical information detailed on the form.

      dh 3040 physical form pdf

    • [PDF File]Admin Requirements - Florida Department of Health

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      Note: Physical exam form must be readable, signed, dated and stamped by the provider. Form DH 3040 or equivalent which meets the above requirements and is signed by a medical doctor (MD), doctor of osteopathy (DO), chiropractor (CP), physician’s assistant (PA), or an advanced registered nurse practitioner (ARNP)

      dh 3040 pdf

    • [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 a legally qualified professional.

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    • [PDF File]RELIGIOUS EXEMPTION FROM IMMUNIZATION Exención Religiosa ...

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      Electronic Signature of Director/Administrator Date County Health Department DH 681, Eff. 7/08, Rule 64D-3.046 (Obsoletes earlier editions) (English) I am the parent or legal guardian of the above-named child. Immunizations are in confl ict with my religious tenets or practices. Therefore, I request that my child be enrolled in

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

      https://info.5y1.org/florida-health-form-dh-3040_1_ea4e35.html

      Guide for Completing the School Entry Health Exam (DH 3040 Form) DH 3040, 6/02, Stock Number: 5744-000-3040-2 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. (formerly s. 232.0315, F.S.) for student entry into Florida

      form dh 3040 florida

    • [PDF File]School District of Palm Beach County

      https://info.5y1.org/florida-health-form-dh-3040_1_42e56c.html

      Sample State of Florida School Health Entry Exam Form (DH 3040) (Parent Portion) This information needs to be distributed to all persons handling student registration and health records. It is also suggested that the parent/guardian notices be included in report card mailings, school newsletters, and PTA/PTO mailings.

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

      https://info.5y1.org/florida-health-form-dh-3040_1_af22e2.html

      Guide for Completing the School Entry Health Exam (DH 3040 Form) DH 3040, 6/02, Stock Number: 5744-000-3040-2 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. (formerly s. 232.0315, F.S.) for student entry into Florida

      florida physical form dh 3040

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