Alabama Department of Public Health Forms

This form is used for Industrial Radiographer on-the-job training (OJT) in Alabama. It includes a Radiographer OJT card for tracking training progress.

This Form is used for individuals to apply for radiographer qualifications in the state of Alabama.

This form is used for applying for a Source Material License in Alabama.

This Form is used for filing a complaint regarding health information privacy and security in Alabama. It allows individuals to report any concerns or violations related to the protection of personal health information.

This form is used for authorizing students or volunteers to access protected health information in the state of Alabama.

This form is used for authorizing the disclosure or requesting of protected health information (PHI) in the state of Alabama.

This form is used for authorized user training and experience and preceptor attestation in the state of Alabama. It is a document that verifies the training and experience of individuals who are authorized to handle radioactive materials.

This Form is used for reporting the assembly of non-certified X-Ray systems in Alabama that are not reported on the Federal Form FD2579.

This Form is used for notifying the acceptance of an amendment to Form D in the state of Alabama.

This Form is used for requesting an accounting of disclosures of personal information in Alabama.

This Form is used for requesting to amend or limit protected health information in Alabama.

This form is used for documenting and tracking an individual's cumulative occupational exposure history in the state of Alabama. It helps to record information about the various job-related exposures to hazardous materials or substances that a person may have been subjected to over time.

This document is used for sending confidential faxes in the state of Alabama.

This Form is used for requesting a release of information in the state of Alabama.

This document is used for declaring U.S. citizenship or lawful presence of an alien in the state of Alabama.

This form is used for applying for an individual critical care endorsement in Alabama. It is specifically for individuals who want to add the critical care specialty to their existing license.

This Form is used for applying to a critical care program in Alabama.

This form is used to request the National Registry Exam in Alabama. The National Registry Exam is a certification exam for emergency medical service providers.

This Form is used to create a list of candidates for election purposes in the state of Alabama. It helps to organize and keep track of individuals running for various positions.

This document is used for reporting accidents involving ambulances in the state of Alabama.

This form is used for applying for an individual licensure as an EMS professional in the state of Alabama.

This Form is used for applying for a EMS Provider Licensure in the state of Alabama.

This form is used to request a pre-adoption or other birth certificate from a sealed file in the state of Alabama.

This form is used for requesting a certified copy of an acknowledgment of paternity in the state of Alabama.

This form is used for applying to obtain a new birth certificate after adoption in Alabama.

This application form is used in Alabama to add the father's name to a child's birth certificate.

This form is used for requesting a keepsake birth certificate in the state of Alabama. It allows residents to obtain a decorative version of their birth certificate for personal or commemorative purposes.

This form is used for making amendments to Alabama birth and death certificates. It is used to request changes or corrections to the information provided on the original certificate.

This document certifies the small entity status of a business in Alabama for the purpose of annual fees.

This document is used to request an exemption for handheld X-ray devices in the state of Alabama.

This Form is used for reporting accidents involving ambulances in the state of Alabama.

This Form is used for requesting general records in Alabama. Please fill out the form to obtain the information you need.

This Form is used for obtaining authorization to release protected health information in Alabama.

This document provides a detailed analysis of the essential job functions required for a specific job position in the state of Alabama. It outlines the key tasks and responsibilities that are necessary for successfully performing the job.

This form is used for applying to request an Alabama birth certificate after a surrogate birth in the state of Alabama.