OR DHS 53-05A 2014 free printable template
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Oregon's law requires proof of immunization be provided or an exemption be signed ... collected on behalf of the Oregon Health Authority, Immunization Program ...
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How to fill out OR DHS 53-05A
How to fill out OR DHS 53-05A
01
Obtain the OR DHS 53-05A form from the official website or your local DHS office.
02
Review the instructions provided on the form carefully.
03
Fill out the personal information section, including your name, address, and contact information.
04
Provide details about the services or assistance you are requesting.
05
Include any necessary identification or verification documents as specified.
06
Review all information for accuracy and completeness.
07
Sign and date the form where indicated.
08
Submit the completed form to the appropriate DHS office either in person or via mail.
Who needs OR DHS 53-05A?
01
Individuals seeking assistance or services from the Oregon Department of Human Services.
02
People applying for specific programs that require documentation of need.
03
Caregivers or guardians applying on behalf of a dependent.
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People Also Ask about
What vaccines are required in Oregon?
Immunization Requirements 2022-2023 4 doses - Diphtheria/Tetanus/Pertussis (DTaP) 3 doses - Polio. 1 dose - Varicella (chickenpox) 1 dose - Measles/Mumps/Rubella (MMR) 3 doses - Hepatitis B. 2 doses - Hepatitis A. 3 or 4 doses - Hib.
What are the 5 types of immunization?
As mentioned earlier, there are five main types of vaccines: attenuated (live) vaccines, inactivated vaccines, toxoid vaccines, subunit vaccines, and conjugate vaccines.
What's the difference between vaccine and immunized?
Vaccination: The act of introducing a vaccine into the body to produce protection from a specific disease. Immunization: A process by which a person becomes protected against a disease through vaccination.
What are the three types of immunization?
There are several types of vaccines, including: Inactivated vaccines. Live-attenuated vaccines. Messenger RNA (mRNA) vaccines.
What vaccines are required by law Oregon?
Oregon requires immunization against 11 vaccine-preventable diseases: Tetanus. Pertussis (whooping cough) Polio. Varicella (chickenpox) Measles. Mumps. Rubella. Hepatitis B.
Does the state of Oregon require vaccinations?
This is also true under Oregon law. On August 19, 2021, Governor Brown announced healthcare workers and all teachers, educators, support staff, and volunteers in K-12 schools would need to be fully vaccinated.
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What is OR DHS 53-05A?
OR DHS 53-05A is a form used by the Oregon Department of Human Services to report and track specific information related to public assistance programs.
Who is required to file OR DHS 53-05A?
Individuals or organizations that provide services or benefits under Oregon public assistance programs are required to file OR DHS 53-05A.
How to fill out OR DHS 53-05A?
To fill out OR DHS 53-05A, you need to provide detailed information as required in the form, including personal identification, service details, and any relevant data requested by the Oregon Department of Human Services.
What is the purpose of OR DHS 53-05A?
The purpose of OR DHS 53-05A is to collect data necessary for program administration, compliance, and evaluation of the effectiveness of public assistance programs in Oregon.
What information must be reported on OR DHS 53-05A?
The information that must be reported on OR DHS 53-05A includes recipient information, types of services provided, dates of service, and any other specifics as outlined by the Oregon Department of Human Services.
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