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L.. 1 -- - -n-- -k- -- - -. h. c O -O. C. -- -. f q ADDRESS s. Unsatisfactory OWNER Correct Violations by Next Inspection S OOAMon PERSON IN CHARGE IWBEGIN END 1- 9 A L / ct JOO i-5 A c2 110 5ld r 2 JMim ZII c3 J ct QIIelllD c3 Jct Q IelllD ot li1 5J ot J d 5l Detention c5 J 1201 Lounge Civic Nursing c6 J r25l c8 rn c8 113 il c8 M School Movie Residen. d Oillt5 ct QIIll5J Child ItiJ 1501 ct m50J ct211M d 2lr5 il of the Florida Ad nindrati e Florida Administrative Code or an administrative...
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Step 1: Obtain a copy of the i-5 form from the health department website or office.
02
Step 2: Read the instructions carefully to familiarize yourself with the requirements.
03
Step 3: Provide personal information, such as your name, address, and contact details, in the designated fields.
04
Step 4: Fill out the health-related questions accurately and thoroughly.
05
Step 5: Attach any necessary supporting documents, such as medical records or test results.
06
Step 6: Review the completed form to ensure all fields are filled correctly and nothing is missing.
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Step 7: Sign and date the form.
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Step 8: Submit the filled-out i-5 form to the health department either in person, via mail, or online as per their instructions.

Who needs i-5 a health department?

01
Individuals who have a health condition, illness, or medical history that requires documentation and evaluation by the health department.
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Healthcare professionals who need to provide information on their patients' health status.
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Employers who are required by law to have their employees undergo health screenings or provide health-related information.
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Organizations or agencies conducting health-related research or studies.
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People seeking certification or permits that involve a health evaluation process.
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i-5 is a form used by the health department to report certain health information.
Healthcare providers and facilities are required to file i-5 with the health department.
i-5 should be filled out with accurate and complete health information as required by the health department.
The purpose of i-5 is to track and monitor health data to improve public health outcomes.
i-5 requires reporting of specific health conditions, treatments, and patient demographics.
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