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This Form is used for individuals or organizations in New Jersey to apply for mini-grant funds through Form FS-77. It provides instructions and guidelines on how to complete the application process.
This form is used for monitoring and documenting the daily staffing levels of other licensed healthcare professionals, such as nurses and therapists, in hospitals across New Jersey.
This Form is used for tracking and documenting the daily patient care staffing levels in the Emergency Department of healthcare facilities in New Jersey.
This form is used for reporting the staffing levels of resident care facilities in New Jersey. It helps ensure that the facilities are adequately staffed to provide proper care to residents.
This Form is used for transferring ownership of a vehicle in New Jersey.
This Form is used for conducting a retrospective immunization audit/survey in New Jersey.
This form is used for the New Jersey Cardiac Cathereterization Data Registry in New Jersey. It collects data related to cardiac cathereterization procedures in the state.
This form is used for tracking flu vaccines in the state of New Jersey. It helps healthcare providers keep records of who has received the flu vaccine and when.
This form is used for submitting specimens for newborn biochemical screening in New Jersey.
This Form is used for completing an Immunization Audit Report worksheet specifically for New Jersey. It helps track and evaluate immunization records for individuals in the state.
This Form is used for making an initial request for newborn screening in New Jersey.
This form is used for the non-confidential release of information in the state of New Jersey.
This form is used for reporting the usage of vaccines in the state of New Jersey. It helps track and monitor vaccination efforts in the region.
This form is used for tracking and monitoring cases of Rubella in New Jersey.
This form is used for tracking and monitoring cases of measles in New Jersey. It helps collect important information about each case to aid in disease surveillance efforts.
This Form is used for reporting cases of perinatal hepatitis-B and their contacts in the state of New Jersey.
This form is used for reporting cases of meningococcal disease in New Jersey.
This form is used to request enrollment in the Early Hearing Detection and Intervention program in New Jersey.
This form is used for enrolling and requesting training for the Early Hearing Detection and Intervention Program in New Jersey.
This Form is used for recording pertussis investigations in the state of New Jersey.
This form is used for tracking cases of mumps in New Jersey. It is a surveillance worksheet used by health authorities to monitor and control the spread of the disease.
This form is used for reporting duplicate records in the New Jersey Immunization Information System (NJIIS).
This form is used for tracking and monitoring cases of tetanus infections in New Jersey. It helps healthcare providers gather essential information to assess the prevalence and control measures for tetanus in the state.
This Form is used for enrolling and requesting training for the New Jersey Immunization Information System (NJIIS).
This Form is used for healthcare providers in New Jersey to request updates to their information for the Vaccines for Children Program.
This form is used for requesting enrollment for a new NJIIS site in New Jersey.
This Form is used for accessing the New Jersey Immunization Information System (NJIIS) and includes a User Confidentiality Statement and Agreement to protect user confidentiality.
This Form is used for requesting disenrollment from a healthcare provider in New Jersey. It is used when an individual wishes to change their healthcare provider or no longer wishes to receive services from their current provider.
This Form is used for requesting a change to the Njiis Immunization Record in the state of New Jersey.
This form is used for enrolling in the Insured for Sure user program in New Jersey.
This form is used for acknowledging the program requirements for the Yellow Fever Vaccine Program in the state of New Jersey.
This form is used for consenting to participate in the New Jersey Immunization Information System (NJIIS).
This form is used for requesting a copy of your Njiis immunization record in the state of New Jersey.
This Form is used for designating additional Yellow Fever Vaccination Centers in New Jersey. It is part of the Yellow Fever Vaccine Program.
This form is used for registrants to withdraw from the New Jersey Immunization Information System (NJIIS).
This Form is used for applying to modify human subjects research in the state of New Jersey. It is required for researchers to submit this form to the Institutional Review Board (IRB) for approval.
This form is used for creating a Uniform Shared Services Agreement for local public health services in New Jersey.
This form is used for requesting account creation and access to the New Jersey Local Health Report system.
This form is used to request microbiological testing of a food sample in the state of New Jersey.