Public Health Templates

This Form is used for renewing medical assistance for Magi-Excepted Households in Hawaii. It provides instructions for completing the renewal form DHS1100B-2.

This form is used for requesting resources or supplies from the local health department in Illinois.

This form is used for reporting the presence of radionuclides in drinking water in the state of Indiana.

This form is used for remitting levies related to brucellosis and tuberculosis in the state of Iowa.

This Form is used for requesting an infectious disease test in the state of Kansas.

This form is used for reporting confirmed or suspected cases of tuberculosis disease in Montana.

This form is used for reporting cases of cholera and other vibrio illnesses to the Centers for Disease Control and Prevention (CDC). It helps in monitoring and tracking the spread of these diseases for public health purposes.

This form is used for recording and reporting health screening results in North Dakota.

This document template provides a public notice regarding the consumption of PFAS-contaminated water in Vermont. It helps inform the public about the potential health risks associated with drinking water containing PFAS chemicals.

Using hand sanitizer is a great step to being thorough when cleaning hands or surfaces. Learning how to make your own hand sanitizer may help you if your local stores run out.

This form is used for reporting cases of the 2019 Novel Coronavirus (Covid-19) in Connecticut.

This form is used for screening public water systems in Connecticut.

This document is a self-isolation agreement specific to Nunavut, Canada. It outlines the terms and conditions individuals must follow when self-isolating in the region.

This Form is used for reporting cases of legionellosis, a type of pneumonia caused by Legionella bacteria.

This form is used for signing a waiver related to the Covid-19 virus in the state of New York. It allows for the release of liability for certain activities during the pandemic.

This Form is used for achieving CCR Certification for water systems in North Dakota that serve 10,000 persons or more. CCR stands for Consumer Confidence Report, which provides information on the quality of drinking water.

This document provides information and guidelines for public education in Vermont following a lead action level exceedance in the water supply.

This form is used to apply for the Medicaid Buy-In program for children in Texas.

This form is used for applying for Medicaid in Texas specifically for breast and cervical cancer patients.

This document provides strategies recommended by the CDC for reducing the consumption of sugar-sweetened beverages. It offers valuable guidance on how to make healthier choices and limit the intake of sugary drinks.

This document examines the level of public trust in vaccines and provides insights into vaccine confidence globally. It discusses the importance of vaccine confidence for public health and highlights key factors that influence public attitudes towards vaccination.

This document discusses the current state of vaccine confidence and the efforts of the Vaccine Confidence Project to promote public trust in vaccines.

This document provides the recommended schedule for child and adolescent immunizations, which includes vaccines for individuals who are 18 years old or younger. It ensures that children and teenagers receive the necessary vaccines to protect against various diseases.

This document establishes the regulations for retail food establishments in Louisiana to ensure sanitary conditions and public health.

This Form is used for reporting reportable conditions in the state of Maine. It is important to submit this form to help track and monitor public health issues in the state.

This form is used for conducting serological testing in the state of Maryland.

This form is used for summarizing information about patients with Acute Flaccid Myelitis (AFM).

This Form is used for reporting cases of trichinellosis, a disease caused by eating undercooked meat infected with Trichinella parasites. It helps the CDC track and monitor the spread of this disease.

This document is for submitting an application to the Animal Population Control Program in New York. It is used to request funding for initiatives aimed at controlling the population of animals.

This document provides a report on the scientific basis for the 2015 Dietary Guidelines. It includes recommendations on nutrition and healthy eating.

This document provides a comprehensive scientific report on the findings and recommendations of the 2020 Dietary Guidelines Advisory Committee. It offers valuable information and insights on nutrition and dietary guidelines for promoting health and well-being.