Get Hhs Phs-7047 2020-2025

Filling out the HHS PHS-7047 form is an essential process for documenting clinical and public health practice hours. This guide provides a step-by-step approach to successfully completing the form online, ensuring that all necessary information is accurately recorded.

Follow the steps to complete the form efficiently.

1. Press the ‘Get Form’ button to access the form and open it in your online editor.
2. In the identification section, enter your name using the format Last, First, Middle Initial. Also, fill in your grade/rank, organization, duty phone number, mobile number, and work email.
3. Specify your category or professional discipline following your current professional license (e.g., nurse, dentist). If applicable, enter your clinical specialty.
4. Complete Item 10 by providing the total number of practice hours you have completed. For Item 11, indicate the start and end dates of the practice hours.
5. For documentation of practice hours, list the city and state location, the name of the facility, and the start and end dates. Enter the number of practice hours and a brief description of the activities completed.
6. Indicate if the practice hours were completed as an official duty activity or a non-official duty activity. Depending on your answer, complete the respective forms required (Form PHS-7085 or Form HHS-520).
7. Complete the certification section by signing and dating the form, confirming that the information provided is accurate and that you understand the implications of false statements.
8. Ensure that your supervisor's information is included in the designated section, providing their printed name, title, signature, and date.
9. Once you have filled out the form, you can save your changes, download a copy for your records, print it if needed, or share it as required.

Complete your HHS PHS-7047 form online today to ensure your clinical and public health hours are accurately documented.