Vermont Department of Health Forms

This form is used for recommending a candidate for the position of Deputy Town Health Officer in Vermont.

This notice is a legal document that informs tenants or property owners of a violation of the health code in their rental housing in the state of Vermont. It serves as a formal warning and outlines the specific violations that need to be addressed.

This form is used for filing complaints and requesting inspections to the Vermont Town Health Officer. It allows residents to report health-related concerns in their town for further investigation.

This document is used for the swearing-in ceremony of a Town Health Officer in the state of Vermont.

This Form is used for recommending a Town Health Officer in the state of Vermont.

This type of document is a meeting agenda for an interdisciplinary team in the Pediatric Palliative Care Program in Vermont. It outlines the topics and agenda items to be discussed during the meeting.

This Form is used for assessing the needs of pediatric patients and their families in the Palliative Care Program in Vermont.

This Form is used for referring children in need of expressive therapy to the Pediatric Palliative Care Program in Vermont. Expressive therapy uses creative arts to help children cope with emotional and physical challenges.

This document outlines the plan of care for children receiving palliative care services in Vermont's Pediatric Palliative Care Program. It includes comprehensive information on the medical treatment, support, and services provided to the child and their family.

This Form is used for requesting additional services for the Pediatric Palliative Care Program (PPCP) in Vermont.

This document is a note for a team meeting or family conference in the Pediatric Palliative Care Program in Vermont. It covers important discussions and decisions related to the care of children with life-limiting conditions.

This application form is used for requesting approval to conduct urine drug testing in the workplace in the state of Vermont.

This document provides a risk assessment for parents and caregivers in Vermont with children aged 6 months to 3 years old. It focuses on evaluating oral health risks in French.

This document is an oral health risk assessment form for parents and caregivers of children aged 6 months to 3 years old in Vermont. It is available in Nepali language. Fill out the form to assess the oral health risks of your child.

This document is an oral health risk assessment form for parents and caregivers of children aged 6 months to 3 years old in Vermont. It provides an opportunity for parents and caregivers to assess the oral health risks and needs of their young children.

This Form is used for parents and caregivers of young children in Vermont to assess oral health risks.

This document is a tool for parents and caregivers in Vermont to assess the oral health risks for children aged 6 months to 3 years old. It provides information on identifying potential oral health problems and offers guidance on promoting dental hygiene and preventing tooth decay in young children.

This form is used for parents and caregivers in Vermont to assess the oral health risks of children aged 6 months to 3 years old.

This document provides an oral health risk assessment for parents and caregivers of children aged 6 months to 3 years in Vermont. It is available in Pashto.

This type of document is used for evaluating oral health risks for parents and caregivers of children aged 6 months to 3 years in Vermont.

This document is used for Clinician Orders for DNR/CPR and other life-sustaining treatments in Vermont.

This document is a training log specifically for grocers participating in the Vermont Women, Infants, and Children (WIC) program. It helps track and document the training activities of grocers in compliance with the WIC program requirements in Vermont.

This form is used for applicants in Vermont who are requesting examination accommodations. It is a questionnaire that aims to gather information about the applicant's specific needs in order to determine the appropriate accommodations for their upcoming examination.

This document is used for obtaining consent for services provided by the Vermont School Dental Health Program. It includes both Tier 1 and Tier 2 consent forms.

This form is used for obtaining Tier 3 consent for dental services provided by the Vermont School Dental Health Program in Vermont.

This form is used for requesting an individual's own prescription monitoring system information in the state of Vermont.

This document is used for registering an advance directive in the Vermont Advance Directive Registry and authorizing any changes to it.

This document is an application form for schools in Vermont to apply for recognition as asthma friendly schools.

This document is the Vermont High School Youth Risk Behavior Survey for students in Vermont. It collects information on various health behaviors and risks among high school students in the state.

This document is a survey conducted in Vermont middle schools to assess the risk behaviors among youth.

This document is used for reporting intentional unsafe acts in the state of Vermont.

This document is used to report adverse events that occurred in Vermont.

This document is for the registration of radiation-producing machines in the state of Vermont. It is important for businesses or individuals operating these machines to comply with regulations and ensure the safe use of radiation.

This document is for applying for a specialized processing method in the state of Vermont.