Public Health Templates

This document outlines the plan for screening individuals for tuberculosis in Illinois correctional facilities.

This document outlines the plan for collecting bacteriological samples in Butte County, California to monitor water quality and ensure public health.

This document provides a task list for new nutritionists working with the Women, Infants, and Children program in New Hampshire. It outlines the specific duties and responsibilities of the position.

This document provides a report on the levels of carbon monoxide in the City of Muckegon, Michigan. It contains important information about the presence of this harmful gas in the city.

This type of document provides guidelines and information on how to ensure compliance with social distancing measures in the community of North Dakota. It includes recommendations for individuals and businesses to help prevent the spread of COVID-19.

This document provides guidance on how to handle medication provision during a disaster in North Dakota. It includes strategies for ensuring access to necessary medications, coordinating with healthcare providers, and prioritizing distribution to affected individuals.

This form is used for tracking and documenting syringe services activities in North Dakota. It helps to monitor the distribution and collection of syringes for harm reduction purposes.

This document is a biannual report that provides information on the syringe services program in North Dakota.

This type of document is a Thm/Haa Analysis Report form that is specific to the state of Illinois.

This document contains information about the testing results of tap water for lead in the state of Illinois. It provides important information regarding the quality and safety of the drinking water supplied to consumers.

This document provides a site plan for monitoring lead and copper levels at 20 sites in Illinois. It outlines the locations and procedures for testing, aiming to reduce the presence of these contaminants in drinking water.

This form is used for obtaining consent from residents in the City of Flint, Michigan to remove lead from their residential properties.

This form is used for appealing an order of isolation, quarantine, or vaccination in the state of Connecticut.

This document describes the implementation of Electronic Case Reporting (ECR) in healthcare facilities in Tennessee. ECR is a digital system used for reporting and monitoring cases of communicable diseases and other public health issues. It aims to improve the efficiency and accuracy of reporting, helping to identify and respond to outbreaks more effectively.

This document is for parents in Vermont who want to refuse consent for newborn screening for their baby. It is available in Nepali language.

This form is used for requesting an exemption from receiving the Covid-19 vaccine in the state of Nebraska.

This document is for registering for the Nebraska Public Health Data Exchange.

This form is used for self-monitoring your temperature in order to track any potential symptoms of COVID-19.

This document provides detailed guidelines and recommendations on the suggested sequence and timeline for immunizations for residents of Alberta, Canada, to protect against various infectious diseases. It is highly beneficial for parents, healthcare providers, and individuals seeking vaccination information.

This form is used for reporting positive Covid-19 test results in the state of Tennessee.

This document provides information about the priority categories for the IHS Loan Repayment Program. The program helps healthcare professionals in certain priority areas repay their loans.

This form is used for Tuberculosis (TB) screening in Washington state for English and Samoan speakers.

This document is used for keeping track of the inventory of rabies vaccines in Illinois. It helps ensure that there is an adequate supply of vaccines to prevent and treat rabies in the state.

This document provides the guidelines for administering higher doses of the Hepatitis B vaccine as per the health regulations of British Columbia, Canada. It includes a detailed schedule for vaccination and other relevant information.

This form is used for obtaining consent for receiving the influenza vaccine and evaluating medical eligibility for vaccination.

This document outlines the protocols for administering influenza vaccinations. It provides guidelines for healthcare providers to follow in order to ensure the efficient and effective distribution of flu shots.

This document provides a summary of influenza vaccination rates among healthcare personnel. It highlights the percentage of healthcare workers who have received the flu vaccine.

This form is used for giving consent for immunization. It ensures that the individual understands and agrees to receive the specified vaccines.

This document provides information about the schedule for receiving Covid-19 vaccinations.