U.S. Department of Health and Human Services Forms

This Form is used for submitting health insurance claims for medical services. It is used by healthcare providers to request payment from insurance companies.

This Form is used for applying for federal assistance. It is the standard form required for many federal grant programs.

This document is a guide that provides information and tips on how adults can stay active and maintain a healthy lifestyle. It offers suggestions for various physical activities and offers guidance on how to incorporate exercise into daily routines.

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.

This IT Strategic Plan outlines the goals and objectives for the use of technology in an organization from 2017 to 2020.

This document explores the concept of self-disclosure and its impact on individuals who receive mental health services. It discusses how sharing personal information can influence the therapeutic relationship and the overall treatment outcomes.

This document provides a comprehensive guide with tips and information on breastfeeding for new mothers.

This guide provides information and tips on breastfeeding for new moms. It covers topics such as the benefits of breastfeeding, how to get started, common challenges, and helpful techniques.

This document provides a list of food sources that are rich in specific nutrients as outlined in the Dietary Guidelines for Americans. It helps individuals identify the best sources of nutrients to include in their diet for optimal health.

This document is a form used to apply for the use of civil money penalty funds.

This form is used for reporting cases of human infection with a new strain of influenza A virus.

This document provides instructions on how to complete the Sudden Unexpected Infant Death Investigation Reporting Form.

This form is used for reporting and investigating sudden unexpected infant deaths. It helps gather important information to determine the cause of these tragic incidents.

This form is used for generating questions related to the national hypothesis of Cyclosporiasis.

This form is used for requesting the student loan repayment benefit from NIH (National Institutes of Health).

This Form is used for ordering transportation services through the National Institutes of Health (NIH). It is used to request transportation for official business purposes such as travel to meetings, conferences, or other events.

This document notifies a person or company that a lien has been placed on their property due to unpaid debts or other obligations. It is important to address the lien to avoid further legal actions.

This form is used for recording contact information for a specific designation or role.

This document provides information about concussions, including symptoms, treatments, and prevention strategies.

This Form is used for certifying the destruction of records. It is used to document the process of destroying outdated or unnecessary records in a business or organization.

This type of document is a checklist and monitoring tool specifically designed for healthcare settings outside of the United States. It assists in the triage of suspected COVID-19 cases. The document is provided in French language.

This form is used for creating a checklist of essential items needed in a pet disaster kit. It helps pet owners prioritize and assemble supplies to ensure the safety and well-being of their pets during natural disasters or emergencies.

This Form is used for reporting the death of a patient with End Stage Renal Disease (ESRD) to the Medical Information System.

This application is supposed to be used by individuals when they want to apply for enrollment in Medicare Part B, insurance which provides outpatient medical coverage.

This Form is used for requesting payment for medical expenses by the patient.

This form is used to report the findings of a comprehensive survey of outpatient rehabilitation facilities.