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A CAL S PC fl N IA 2012 YOUTH SPORTS FUNDING ORGANIZATION INFORMATION Please PRINT legibly. D Mailing address P t Name of organization fl3 S Chairperson DCA Treasurer Website L v .2cL tact email (no)
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A d p pox stands for Declaration of Potential Pox.
Businesses and individuals who may have been exposed to a potential pox are required to file a d p pox.
To fill out a d p pox, you need to provide details on your potential exposure and any symptoms you may be experiencing.
The purpose of a d p pox is to track and monitor potential pox cases and prevent further spread of the infection.
Information such as date of exposure, symptoms, and contact information must be reported on a d p pox.
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