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State Form 53700 Indiana Initial Refugee Health Assessment - Indiana
What Is State Form 53700?
This is a legal form that was released by the Indiana State Department of Health - a government authority operating within Indiana. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form 53700?
A: Form 53700 is the Indiana Initial Refugee Health Assessment form.
Q: What is the purpose of Form 53700?
A: The purpose of Form 53700 is to conduct an initial health assessment for refugees settling in Indiana.
Q: Who is required to complete Form 53700?
A: Healthcare providers in Indiana are required to complete Form 53700 for refugees.
Q: What information is included in Form 53700?
A: Form 53700 includes information about the refugee's medical history, immunizations, and physical examination findings.
Form Details:
- Released on March 1, 2010;
- The latest edition provided by the Indiana State Department of Health;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of State Form 53700 by clicking the link below or browse more documents and templates provided by the Indiana State Department of Health.
Download State Form 53700 Indiana Initial Refugee Health Assessment - Indiana
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