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COMMUNITY HEALTH NEEDS ASSESSMENT ADVISORY COUNCIL MEETING GROUP:BROWARD HEALTH COMMUNITY HEALTH NEEDS ASSESSMENTFACILITATORS:Jasmin D. Shirley, VP, Broward Health, Community Health Services Mark
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Here is how to fill out Broward Health Community Health form:
02
Start by downloading the Broward Health Community Health form from the official website or obtain a physical copy from a Broward Health center.
03
Begin by providing your personal information, including your full name, contact information, and date of birth.
04
Fill in your current address, including the street, city, state, and zip code.
05
Indicate your primary care physician’s name and contact information if applicable.
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Specify your preferred language for communication with Broward Health.
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Fill out the section related to your insurance information, including the name of your insurance provider, policy number, and any other relevant details.
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If you don't have health insurance, there may be a separate section to fill out regarding your income and any financial assistance you may require.
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Read and agree to the terms and conditions stated in the form, which may include consent for treatment and information sharing.
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Review the completed form to ensure all information is accurate and legible before submitting it.
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Submit the form to the designated Broward Health office or facility by mail, fax, or in person.

Who needs broward health community health?

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Broward Health Community Health is available for individuals who meet certain criteria:
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Individuals residing in Broward County, Florida.
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Individuals who are in need of healthcare services, including primary care, specialty care, preventive care, and more.
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Individuals who may not have health insurance or have limited access to healthcare.
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Individuals who require financial assistance or are on a low income.
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Broward Health Community Health is a program aimed at improving the health and well-being of the community through various initiatives and services.
Healthcare providers, community organizations, and other stakeholders are required to file Broward Health Community Health reports.
To fill out Broward Health Community Health reports, stakeholders must provide detailed information on their initiatives, services, and outcomes.
The purpose of Broward Health Community Health is to track and evaluate the impact of health initiatives on the community and identify areas for improvement.
Stakeholders must report on the types of services provided, the number of individuals served, outcomes achieved, and any challenges faced.
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