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Form DH1623 Cumulative Occupational Exposure History - Florida
What Is Form DH1623?
This is a legal form that was released by the Florida Department of Health - a government authority operating within Florida. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form DH1623?
A: Form DH1623 is the Cumulative Occupational Exposure History Form used in the state of Florida.
Q: What is the purpose of Form DH1623?
A: The purpose of Form DH1623 is to collect information about an individual's occupational exposure history.
Q: Who is required to fill out Form DH1623?
A: Workers who have been exposed to hazardous materials or conditions in their occupation in the state of Florida are required to fill out Form DH1623.
Q: What information is included in Form DH1623?
A: Form DH1623 includes information such as the individual's name, current address, occupation, employer, and details about the exposure to hazardous materials or conditions.
Q: Is Form DH1623 confidential?
A: Yes, information provided on Form DH1623 is considered confidential and is protected by privacy laws.
Q: Can Form DH1623 be used for legal purposes?
A: Yes, the information provided on Form DH1623 can be used for legal purposes related to workers' compensation or occupational health claims.
Form Details:
- Released on May 1, 1997;
- The latest edition provided by the Florida 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 printable version of Form DH1623 by clicking the link below or browse more documents and templates provided by the Florida Department of Health.
Download Form DH1623 Cumulative Occupational Exposure History - Florida
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