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I D A H 0 DEPARTMENT OF HEALTH WELFARE C. L 'BUTCH OUTER Governor RICHARD M. ARMSTRONG Director TAMARA PRISON ADMINISTRATOR DIVISION OF LICENSING & CERTIFICATION DEBRA RANSOM, RN., R.H.I.T., Chief
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This form refers to a specific health and welfare report in Idaho.
Certain organizations or entities in Idaho are required to file this report.
The form must be filled out according to the instructions provided by the health and welfare department in Idaho.
The purpose of this report is to gather important health and welfare data for analysis and decision-making.
Information such as health statistics, welfare programs, and demographic data may need to be reported on this form.
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