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Date / / LED CM initiated: / / Was LED notified of ELL by PCP? Date: Last Nm: First Nm: MI:DOB: / / Siblings 6 years of age? Pt. Address:City/ST/ZIP Parents/Guardian: Phone: Initial BLL: Confirm 15
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Anyone who wants to initiate a LHD CM (Local Health Department Case Management) may need to fill out the LHD CM initiated form. This form is typically required for individuals who require case management services from their local health department. It is important to check with the specific health department or relevant authorities to determine if this form is necessary in your particular case.

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Lhd cm initiated stands for Local Health Department Case Management Initiated.
Local health departments are required to file lhd cm initiated.
Lhd cm initiated form should be completed with the necessary information regarding case management activities.
The purpose of lhd cm initiated is to track and manage cases handled by local health departments.
Information such as case details, interventions, outcomes, and follow-up actions must be reported on lhd cm initiated.
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