NC DHHS 3987 2020-2025 free printable template
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North Carolina Department of Health and Human Services Women's and Children's Health Section Immunization Branch NC MEDICAL EXEMPTION STATEMENT FORM HHS 3987 Purpose: To provide physicians licensed
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How to fill out NC DHHS 3987
How to fill out NC DHHS 3987
01
Obtain the NC DHHS 3987 form from the official North Carolina DHHS website.
02
Read the instructions carefully before you start filling out the form.
03
Fill in your personal information including name, address, and phone number in the designated fields.
04
Provide the required details about the services you are requesting.
05
Ensure you include any necessary documentation as specified in the instructions.
06
Review the completed form for accuracy and completeness.
07
Sign and date the form where indicated.
08
Submit the form to the appropriate DHHS office as instructed.
Who needs NC DHHS 3987?
01
Individuals seeking assistance or services from the North Carolina Department of Health and Human Services.
02
Service providers or organizations that need to report or update information to DHHS.
03
Anyone applying for certain benefits or programs offered by the NC DHHS.
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People Also Ask about
Are vaccines mandatory in North Carolina?
North Carolina law requires all children in the state to receive certain immunizations.12th Grade. VaccineNumber Doses Required Before School Entry*Hepatitis B (Hep B)3 dosesVaricella (chickenpox)1 doseTetanus/diphtheria/pertussis1 doseMeningococcal conjugate (Effective 2020-2021 School Year)2 doses6 more rows • Jul 23, 2020
What is an example of a religious exemption letter in NC?
I, _ am requesting a religious exemption from vaccination against the disease(s) or condition(s) marked below. I understand that this exemption is allowed solely for sincerely held religious beliefs and not for political, social, or other personal views.
Does North Carolina require vaccines for school?
North Carolina law requires all children in the state to receive certain immunizations. Records are checked when children enter school or child care. Information in this section is categorized ing to school or grade level.
How do I get a religious exemption in NC?
In order to claim a religious exemption, the student requesting the exemption must write a statement of their religious objection to immunization, including the name and date of birth. This statement should be provided to the school in place of an immunization record.
Does North Carolina have vaccine exemptions?
North Carolina law provides for two types of exemptions from required immunizations. They are medical and religious. Learn more about these exemptions, and the process for requesting an exemption for your children.
What are the exemptions for vaccines in North Carolina?
North Carolina law provides for two types of exemptions from required immunizations. They are medical and religious. Learn more about these exemptions, and the process for requesting an exemption for your children.
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What is NC DHHS 3987?
NC DHHS 3987 is a form used by the North Carolina Department of Health and Human Services for reporting specific information related to health and human services programs.
Who is required to file NC DHHS 3987?
Entities or individuals who receive certain health and human services benefits or funding may be required to file NC DHHS 3987, as mandated by state regulations.
How to fill out NC DHHS 3987?
To fill out NC DHHS 3987, you should gather the required information, follow the instructions provided with the form, complete all requested sections accurately, and submit it by the specified deadline.
What is the purpose of NC DHHS 3987?
The purpose of NC DHHS 3987 is to collect necessary data to ensure compliance with state regulations and to monitor the effectiveness and efficiency of health and human services programs.
What information must be reported on NC DHHS 3987?
The information that must be reported on NC DHHS 3987 includes participant details, program participation rates, financial information, and any other specified data as per the guidelines.
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