DOH Form 422-111 Birth Parent Medical History - Washington

DOH Form 422-111 Birth Parent Medical History - Washington

What Is DOH Form 422-111?

This is a legal form that was released by the Washington State Department of Health - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is DOH Form 422-111?
A: DOH Form 422-111 is a form used in Washington state to collect medical history information from birth parents.

Q: Who needs to fill out DOH Form 422-111?
A: Birth parents in Washington state are required to fill out DOH Form 422-111.

Q: What is the purpose of DOH Form 422-111?
A: The purpose of DOH Form 422-111 is to gather important medical history information from birth parents to assist in the care and well-being of their child.

Q: Are birth parents obligated to fill out DOH Form 422-111?
A: Yes, birth parents in Washington state have a legal obligation to fill out DOH Form 422-111.

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Form Details:

  • Released on August 1, 2018;
  • The latest edition provided by the Washington State Department of Health;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of DOH Form 422-111 by clicking the link below or browse more documents and templates provided by the Washington State Department of Health.

Download DOH Form 422-111 Birth Parent Medical History - Washington

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