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Get the free Screen Date 12 Month Form - dhhr wv

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Screen Date___West Virginia Department of Health and Human Resources Early and Periodic Screening, Diagnosis, and Treatment (EPS DT) Hatcheck Program Preventive Health Screen12 Month Forename___ DOB___
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Go to the screen date 12 month section on the application or website.
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Select the date option for the 12th month.
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Fill in the corresponding field with the required information for that month.
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People who are required to provide data or information for the entire year, where the 12th month is significant.
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Screen date 12 month refers to the date exactly twelve months prior to the current date.
All individuals or entities who were active or had relevant events during the 12-month period being screened.
Screen date 12 month can be filled out by providing accurate and detailed information about activities, events, and transactions that took place during that period.
The purpose of screen date 12 month is to track and report relevant activities, events, and transactions that may have an impact on current operations or decisions.
Information such as financial transactions, acquisitions, mergers, partnerships, legal disputes, and other significant events must be reported on screen date 12 month.
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