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Get the free DHS Certificate of Child Health Examination Form - Spanish History Section

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FOR USE IN CFS LICENSED CHILD CARE FACILITIES CFS 600 Rev 12/2011State of Illinois Certificate of Child Health Examination Students Rebirth DateSexRace/EthnicitySchool /Grade Level/ID# LastFirstMiddleMonth/Day/Year AddressStreetCityParent/Guardianship
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How to fill out dhs certificate of child

01
To fill out the DHS certificate of child, follow these steps:
02
Begin by entering the child's full name in the designated space.
03
Provide the child's date of birth, including the month, day, and year.
04
Indicate the child's gender by selecting either male or female.
05
Enter the child's current address, including street, city, state, and ZIP code.
06
Specify the child's nationality and whether they have dual citizenship.
07
If applicable, provide the child's parent/guardian information, including their full names, contact numbers, and addresses.
08
Include any additional details or notes about the child, such as allergies or medical conditions.
09
Review the completed form for accuracy and ensure all necessary information is included.
10
Sign and date the certificate to validate and authorize the provided information.
11
Submit the filled-out DHS certificate of child to the appropriate authority or department for processing.

Who needs dhs certificate of child?

01
Any individual or legal entity who requires official documentation proving the identity and personal information of a child may need a DHS certificate of child.
02
This may include parents, guardians, educational institutions, healthcare providers, government agencies, or any other organization or individual responsible for the child's well-being and records.
03
The specific requirements for obtaining a DHS certificate of child may vary depending on the jurisdiction and purpose of the document.
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The dhs certificate of child is a document issued by the Department of Human Services that certifies the eligibility of a child for certain benefits or services.
Parents or legal guardians of the child are required to file the dhs certificate of child.
The dhs certificate of child can be filled out online on the Department of Human Services website or in person at a local office.
The purpose of the dhs certificate of child is to verify the age and eligibility of a child for government benefits or services.
The dhs certificate of child requires information such as the child's name, date of birth, parent or guardian's contact information, and proof of eligibility.
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