Syringe Service Enrollment and Daily Log Form is a legal document that was released by the New Mexico Department of Health - a government authority operating within New Mexico.
Q: What is the Syringe Service Enrollment and Daily Log Form?
A: The Syringe Service Enrollment and Daily Log Form is a document used in New Mexico for the registration and tracking of syringe exchange program participants.
Q: Why is the form necessary?
A: The form is necessary to ensure proper enrollment in the syringe exchange program and to track the distribution and return of syringes.
Q: Who needs to fill out this form?
A: This form needs to be filled out by individuals who wish to participate in the syringe exchange program in New Mexico.
Q: Is this form confidential?
A: Yes, the information provided on this form is confidential and protected by law.
Q: What information is required on the form?
A: The form requires basic personal information, such as name, date of birth, and contact information.
Q: How often do I need to fill out this form?
A: You typically need to fill out this form only once when enrolling in the syringe exchange program, but you may be required to update your information periodically.
Q: What is the purpose of the daily log section?
A: The daily log section is used to track the number of syringes distributed and returned each day by participant.
Q: Can I remain anonymous when filling out this form?
A: Yes, you have the option to remain anonymous when filling out this form, but providing accurate contact information can help with program follow-up.
Q: Are there any eligibility requirements to participate in the syringe exchange program?
A: No, there are no specific eligibility requirements to participate in the syringe exchange program in New Mexico.
Form Details:
Download a printable version of the form by clicking the link below or browse more documents and templates provided by the New Mexico Department of Health.