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FOR CCC USE ONLY CULLMAN COUNTY COMMISSION HEALTH INSURANCE 2017 DECLINATION OF COVERAGE FORM Revised 1/17 Date Initials SUBSCRIBER INFORMATION Please print or type. Persons requesting special enrollment must notify the Cullman County Commission in writing within 30 days of the qualifying event. Notification must include 1. a letter requesting participation in the special enrollment and 2. a completed Enrollment form and 3. Full-time Date of Hire Notes PERSONNEL DEPARTMENT 500 2ND AVENUE SW...
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The Cullman County Commission Health refers to the health regulations and requirements set by the Cullman County Commission.
All individuals and businesses operating within Cullman County are required to file the Cullman County Commission Health form.
The Cullman County Commission Health form can be filled out online or in person at the Cullman County Commission office. It requires information about the health practices and procedures of the individual or business.
The purpose of the Cullman County Commission Health is to ensure that individuals and businesses in Cullman County adhere to health regulations and maintain a safe environment.
The Cullman County Commission Health form requires information about health practices, procedures, and compliance with health regulations.
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