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DEPARTMENT OF PUBLIC HEALTH & HUMAN SERVICES Quality Assurance DivisionLicensure Bureau 2401 Colonial Drive P.O. Box 202953 Helena, MT 596202953 FAX: (406) 4441742 APPLICATION FOR MONTANA STATE HEALTH

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What is infirmary application?

Infirmary application is a form used to request medical care or treatment for individuals who are ill or injured.

Who is required to file infirmary application?

Any individual who is seeking medical attention or treatment at a designated infirmary or medical facility.

How to fill out infirmary application?

Infirmary application can be filled out by providing personal information, details of the illness or injury, and any other relevant medical history.

What is the purpose of infirmary application?

The purpose of infirmary application is to ensure that individuals receive timely and appropriate medical care for their illness or injury.

What information must be reported on infirmary application?

Information such as personal details, medical history, symptoms, and any relevant documents related to the illness or injury.

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