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DEPARTMENT OF STATE HEALTH SERVICES Environmental & Consumer Safety Section P.O. Box 149347 Austin, Texas 787149347No.15808Date 9/18/14, Firm Domenico Produce Co Inc. Person ContactedClassification
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Step 1: Obtain the Department of State Health form from their website or local office.
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Step 2: Carefully read the instructions provided with the form to understand the requirements.
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Step 3: Fill out the personal information section accurately, including your name, address, contact information, and any other details requested.
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Step 4: Provide details regarding your health history, such as any medical conditions or medications you are currently taking.
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Step 5: If required, attach any supporting documents or medical reports mentioned in the instructions.
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Step 6: Double-check all the filled information for accuracy and completeness.
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Step 7: Sign the form where indicated.
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Step 8: Submit the completed form to the Department of State Health either online or through mail, as instructed.

Who needs department of state health?

01
Anyone who is required by law or regulation to provide information or documentation regarding their health to the state government.
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Individuals applying for certain permits, licenses, or certificates that involve health-related matters may also need to fill out the Department of State Health form.
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Healthcare providers or institutions involved in certain programs or activities governed by the state health department may also be required to furnish relevant information.
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