Florida Department of Health Forms

This document is used for screening and recording patient eligibility for the Vaccines for Children Program offered at Family Planning Clinics in Florida.

This form is used for logging VFC vaccine information for unaccompanied minors without insurance at a Family Planning Clinic in Florida.

This form is used for providing additional information required for the Florida Vaccines for Children Program in Florida.

This document is a cooler temperature log specifically for off-site immunization activities in the Florida Vaccines for Children (VFC) Program. It helps to ensure that vaccines are stored at the correct temperature during transportation and administration.

This form is used for reporting the monthly radon exposure levels in Florida for individuals working in a certain level.

This document outlines the procedure for calculating the Committed Effective Dose Equivalent (CEDE) at medical facilities in Florida. It provides guidance on how to measure and evaluate the radiation doses received by staff and patients at these facilities.

This form is used for requesting the equivalency of a Cardiopulmonary Resuscitation (CPR) or Advanced Cardiac Life Support (ACLS) course in Florida.

This form is used for applying for a ground ambulance service provider license in Florida's Emergency Medical Services Program.

This form is used for applying for vehicle permits for Emergency Medical Services in Florida.

This Form is used for applying for an air ambulance service license for the Emergency Medical Services Program in Florida.

This document is a narrative report used for conducting inspections of emergency medical services in the state of Florida. It provides a detailed account of the conditions and practices observed during the inspection.

This document provides the test results for emergency medical services equipment in Florida.

This form is used for conducting vehicle inspections for neonatal interfacility transport in Emergency Medical Services in Florida.

This form is used for transferring patients between healthcare facilities in the state of Florida. It ensures all relevant medical information and care is communicated accurately during the transfer process.

This type of document is an Advanced Life Support Vehicle Inspection Report specific to the Emergency Medical Services in the state of Florida. It is used to record and document the inspection of advanced life support vehicles used by emergency medical services in Florida.

This document is used for inspecting Basic Life Support vehicles used by Emergency Medical Services in Florida. It ensures that the vehicles meet the necessary requirements for providing emergency medical care.

This document is used for maintaining personnel records of individuals employed in the Emergency Medical Services field in the state of Florida. It contains information such as employment history, training records, and certifications of EMS personnel.

This form is used for emergency medical services in Florida to document corrective action taken after an inspection.

This document is used for reporting service records and conducting facility inspections for emergency medical services in Florida.

This form is used for registering radiation machine facilities in the state of Florida.

This form is used for radiation machine vendors in Florida to register.

This document provides guidelines and regulations for industrial registrants in Florida who use cabinet or baggage radiation machines. It outlines a radiation protection program to ensure safety and compliance with regulations.

This document provides guidelines and regulations for a radiation protection program specific to bone densitometry procedures in the state of Florida. It covers safety measures to ensure minimal exposure to radiation for patients and healthcare professionals.

This document outlines the radiation protection program that veterinary registrants in Florida must follow to ensure the safety of both animals and staff from radiation exposure.

This document describes the radiation protection program required for mammography registrants in the state of Florida. It outlines the guidelines and regulations that must be followed to ensure the safety of patients undergoing mammography procedures.

This document provides a checklist for applying for an HDR Remote Afterloader license in Florida. It includes the required documents and steps needed for the application process.

This document provides a checklist for applying for a portable gauge license in Florida. It outlines the necessary steps and requirements for obtaining the license.

This document provides a checklist for individuals applying for a fixed gauge license in the state of Florida. The checklist outlines the required documents and steps that must be completed in order to obtain a fixed gauge license.

This document is used for keeping track of radioactive sealed sources and devices in Florida. It provides an inventory of these materials to ensure proper management and safety.

This form is used for obtaining a certificate for conducting in vitro testing with radioactive material under general license in the state of Florida.

This form is used for obtaining a certificate for the medical use of radioactive material under general license in the state of Florida.

This form is used to record a person's cumulative occupational exposure history in the state of Florida. It helps to keep track of the various jobs and industries someone has worked in to determine potential health risks associated with exposure to certain substances or hazards.

This document is a report that pertains to the transfers of industrial devices to general licensees in Florida.

This form is used for the verification of nuclear medicine procedures and treatments in the state of Florida.

This document outlines the procedure for calculating the Total Effective Dose Equivalent (TEDE) in the state of Florida. It provides step-by-step instructions on how to determine the radiation exposure levels.

This document provides the procedure for calculating the Deep Dose Equivalent (DDE) in Florida. It outlines the steps and guidelines for determining the DDE, which is a measure of radiation exposure.

This document provides the procedure for calculating the Committed Effective Dose Equivalent (CEDE) in the state of Florida.

This document describes the procedures and guidelines for the Alara Model in the state of Florida. It provides step-by-step instructions for implementing the Alara Model in various settings.

This Form is used for submitting bacteriological food samples in the state of Florida. It helps in collecting information about the food sample and its potential contaminants for further analysis and investigation.

This Form is used for ordering Covid-19 testing supplies in Jacksonville, Florida for shipping and receiving purposes.