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DC GOVERNMENT

info@dc.gov

Office of the Chief Technology Officer, Washington, DC, US

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10/22/2024Click to Sign
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Upload Attachment(s)

Please upload the following attachments. The Universal Health Certificate (front and back side) is required to submit the form. Other documents may be required depending on your child's medical condition.

There is a 250MB limit on each attachment.

Universal Health Certificate (Physical) - front side Click Here to Upload
Universal Health Certificate (Physical) - back side Click Here to Upload
Asthma Action Plan (if needed) Click Here to Upload
Anaphylaxis Action Plan (if needed) Click Here to Upload
Any Additional Paperwork from Doctor (if needed) Click Here to Upload
Any Additional Paperwork from Doctor (if needed) Click Here to Upload