Syringe Service Enrollment and Daily Log Form - New Mexico

Syringe Service Enrollment and Daily Log Form - New Mexico

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.

FAQ

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.

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Form Details:

  • Released on July 1, 2017;
  • The latest edition currently provided by the New Mexico Department of Health;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

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.

Download Syringe Service Enrollment and Daily Log Form - New Mexico

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