Rhode Island Department of Health Forms

This document is for applying for licenses to operate harm reduction centers in Rhode Island.

This form is used for requesting and releasing Rhode Island Hospital discharge data.

This document is for assessing the quality of drinking water in Rhode Island.

This document is for assessing the quality of drinking water in Rhode Island. It is conducted by the Center for Drinking Water Quality.

This document is an application for obtaining a license as a Licensed Clinical Social Worker (LCSW) or Licensed Independent Clinical Social Worker (LICSW) in Rhode Island. It is specifically for the clinical exam.

This form is used for reporting the transfer of care for individuals with HIV in Rhode Island.

This document is a case report form used in Rhode Island for recording perinatal HIV exposure cases. It helps in tracking and monitoring instances of HIV transmission from mother to child during pregnancy, delivery, or breastfeeding.

This Form is used for Rhode Island medical physicists or ophthalmic physicists to provide information about their training, experience, and mentorship.

This Form is used for Authorized User Training, Experience and Preceptor Attestation in Rhode Island.

This form is used for attesting the training, experience, and preceptorship of an authorized nuclear pharmacist in Rhode Island.

This form is used for training, experience, and preceptor attestation for authorized users in Rhode Island.

This form is used for attestation of training, experience, and a preceptor for Radiation Safety Officers or Associate Radiation Safety Officers in Rhode Island.

This Form is used for applying for a license to handle radioactive materials in Rhode Island. It provides instructions on how to complete the MAT-1A application form.

This document is used for declaring the person responsible for a minor to participate in activities in Rhode Island.

This document provides a comprehensive guide on the recommended schedule for routine childhood immunizations in Rhode Island using state-supplied vaccines. It serves as a reference for healthcare providers and parents to ensure timely and effective immunization.

This form is used by participants in Rhode Island's Medical Marijuana Program to officially report any changes in their personal information, such as address change, caregiver details, or alteration in medical condition.

This document is an application form for individuals who want to obtain a license as a Mental Health Counselor Associate in the state of Rhode Island.

This document is for declaring the person responsible for a minor to participate in Rhode Island's Medical Marijuana Program.

This form is used for referring patients to the Pulmonary Rehabilitation Program in Rhode Island.