Public Health Templates

This document provides instructions for HIV prophylaxis (NPEP) and supplemental reimbursement in the state of Ohio. It outlines the steps and requirements for accessing and receiving reimbursement for HIV prevention medication and services.

This form is used for recording the usage of intranasal naloxone in the state of Oklahoma.

This form is used for reporting incidents that occur at public bathing places in the state of Oklahoma.

This document provides action steps for public health practitioners regarding self-measured blood pressure monitoring. It offers guidance on how to promote and implement this practice for better health outcomes.

This type of document is used for documenting and managing information related to a diabetic condition within the U.S. Air Force.

This Form is used for reporting food and food-related bacteriology testing results in the state of Washington.

This Form is used for submitting an annual summary report for the Cross-connection Control Program in Washington state.

This form is used for reporting the annual summary of cross-connection control activities for public water systems in Washington state.

This door hanger is used in Washington to inform residents about the importance of boiling water. It is available in English and Spanish.

This form is used for reporting Mycobacterium isolates in the state of Washington. It is essential for tracking and monitoring the presence of this bacterium in the public health system.

This document is a confidential report for the testing and diagnosis of Latent Tuberculosis Infection (LTBI) in the state of Rhode Island.

This form is used for reporting adult HIV cases in a confidential manner in the state of Rhode Island.

This form is used for reporting the analytical results for lead and copper monitoring in South Carolina.

This Form is used for submitting samples for bacteriological analysis in South Carolina.

This form is used for applying for an exemption from the regulation of arsenic in Utah.

This form is used for reporting cases of reportable diseases in Utah.

This form is used for implementing the Lead and Copper Rule Sampling Plan in the state of Vermont to ensure safe drinking water by monitoring the levels of lead and copper contaminants.

This document provides an operational evaluation report on disinfection byproducts in Vermont. It details the findings and recommendations for improving water treatment processes to minimize the formation of these byproducts.

This document provides national statistics and data on diabetes. It includes information on the prevalence, risk factors, and impact of diabetes in the United States.

This checklist is used for conducting a sanitary survey in Utah to ensure that water systems meet the necessary health and safety standards.

This document provides a coliform sampling plan for public water systems in Vermont with a population over 1,000, in accordance with the Revised Total Coliform Rule (RTCR).

This report provides an overview of the current state of air quality worldwide, highlighting the key findings and trends observed in 2019. It includes information on pollution levels, health impacts, and progress made in improving air quality.

This form is used for reporting cases of Varicella (chickenpox) in the state of New Jersey.

This document provides instructions for water treatment facilities in Iowa that are applying for an NPDES permit. It outlines the steps and requirements for the application process.

This form is used for methadone programs in California that are serviced by this laboratory.

This form is used for conducting lead assessments by public health nurses in the state of Illinois.

This document provides a sample general letter for Illinois parents/guardians regarding measles.

This form is used for receiving advisory updates regarding infectious diseases in Kansas.

This Form is used for obtaining consent for immunizations required for students in New Mexico schools.

This form is used for long term care facilities in Illinois to notify the appropriate authorities of any changes or updates.

This Form is used for tracking tetanus cases in New Jersey. It is a surveillance worksheet that provides instructions for reporting and documenting information related to tetanus cases.

This form is used for reporting cases of Borrelia miyamotoi infection in Connecticut.

This form is used for creating an Arthropod Management Plan specifically for public lands in the state of Florida. It helps in planning and implementing strategies to manage arthropod populations for the conservation and protection of public lands.