Get Chfs 219

The CHFS 219 is a crucial confidentiality and security agreement for individuals accessing confidential information within the Cabinet for Health and Family Services. This guide offers a clear, step-by-step approach to successfully complete the form online.

Follow the steps to complete the Chfs 219 online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Fill in your last name, first name, and middle initial in the designated fields at the top of the form.
3. Review the confidentiality agreement statement carefully to ensure you understand your responsibilities concerning confidential information.
4. Complete the 'Print Name' field with your full name as you want it to appear on the document.
5. Provide your email address in the respective field to ensure communication on relevant matters.
6. Enter the clinic name where you are employed in the appropriate section.
7. If applicable, fill in your Vaccines for Children (VFC) PIN number, using the correct format.
8. Indicate your role in the clinic in the corresponding field to clarify your responsibilities.
9. Respond to the question regarding your ability to give immunizations by selecting either 'Yes' or 'No'.
10. Include the clinic's phone number to provide a means of contact for further inquiries.
11. Once all fields are completed, review your entries for accuracy before signing the document digitally or physically, as required.
12. Save changes, then download, print, or share the completed form as necessary.

Complete your Chfs 219 form online today to ensure compliance and safeguard confidential information.