Form IMM-34 Site Enrollment Request: Early Hearing Detection and Intervention Program - New Jersey

What Is Form IMM-34?

This is a legal form that was released by the New Jersey Department of Health - a government authority operating within New Jersey. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is the IMM-34 Site Enrollment Request?
A: The IMM-34 Site Enrollment Request is a form used to request enrollment in the Early Hearing Detection and Intervention Program in New Jersey.

Q: What is the Early Hearing Detection and Intervention Program?
A: The Early Hearing Detection and Intervention Program is a program aimed at ensuring that all infants and toddlers in New Jersey receive appropriate hearing screening and intervention services.

Q: Who can use the IMM-34 Site Enrollment Request form?
A: This form can be used by health care providers and organizations in New Jersey who wish to enroll as a site in the Early Hearing Detection and Intervention Program.

Q: What information is required on the IMM-34 form?
A: The IMM-34 form requires information such as contact details, organization information, service details, and certification information.

Q: How can I submit the IMM-34 Site Enrollment Request form?
A: The completed form can be submitted via mail or fax to the New Jersey Department of Health.

Q: Is there a fee for submitting the IMM-34 Site Enrollment Request form?
A: No, there is no fee required to submit the IMM-34 Site Enrollment Request form.