Please rate Form Mdch Bcal 3305 1-22
Fill out the information requested in Section I; the remaining sections are to be completed by a doctor, nurse, dentist, dental therapist, and dental hygienist.
Bring: be sure to bring the child's immunization records to the examination.
Section III: may be certified by the transcription of information from the certificate of immunization.
Section III: statements such as "UP-TO-DATE" or "COMPLETE" will not be accepted.
Public Act 368 of 1978: any child enrolling in a Michigan school for the first time must be adequately immunized, vision tested and hearing tested.
Exemptions: granted for medical, religious, and other objections, provided that the waiver forms are properly prepared, signed and delivered to school administrators.
| Question | Answer |
|---|---|
| Form Name | MDHHS-3305 |
| Form Length | 4 pages |
| Fillable? | Yes |
| Fillable fields | 241 |
| Avg. time to fill out | 41 min |
| Edition | 1-22 |
| Issuing agency | Michigan Department of Health and Human Services |
| Other names | MDHHS-3305, MDHHS 3305, Health Appraisal, Michigan health appraisal form |
| Official source | MDHHS-3305 (Rev 1-22), Michigan Department of Health and Human Services |
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Please rate Form Mdch Bcal 3305 1-22
