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State of New Jersey Department of Health Division of Medicinal Marijuana ALTERNATIVE TREATMENT CENTER PERMIT REQUEST FORMS PERSONAL HISTORY DISCLOSURE FORM 2You must use the latest version of Adobe

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How to fill out form department of health

1. Gather all the required information and documents, such as your personal details, medical history, and any supporting documents.
2. Read the instructions provided with the form to understand the specific requirements and guidelines for filling it out.
3. Start by entering your personal information, including your name, address, contact details, and date of birth.
4. Provide the necessary information about your medical history, such as any past illnesses, treatments, medications, or allergies.
5. Fill out any additional sections or questions related to your specific situation, such as previous surgeries or family medical history.
6. Double-check all the information you have entered to ensure accuracy and completeness.
7. Once you are confident that the form is correctly filled out, sign and date it as required.
8. Make a photocopy or digital copy of the completed form for your records, if necessary.
9. Submit the form to the Department of Health by following the designated submission method, which may include mailing it, submitting it online, or hand-delivering it to a specific office.
10. Keep track of any confirmation or acknowledgment you receive from the Department of Health regarding the form submission.
11. If you have any questions or need assistance, contact the Department of Health's helpline or visit their website for further guidance.

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1. The form Department of Health may be needed by individuals who require medical services, such as patients seeking treatment, individuals applying for medical programs or assistance, healthcare professionals, researchers, or anyone else who needs to provide their health-related information to the Department of Health.

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