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CLIFTON HEALTH DEPARTMENT 900 Clifton Ave., Clifton, NJ 07013 (973) 4705760 ADULT INFLUENZA CONSENT FORM NAME (please print) MALE ()ADDRESS: CITY: PHONE #: (If City Employee)BIRTHDATE: / / Department:
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Clifton Health Department is a government organization that ensures public health and safety in the city of Clifton.
Certain businesses and individuals may be required to file with the Clifton Health Department depending on the type of operation.
To fill out the Clifton Health Department forms, you may need to provide information about your business or personal health history.
The purpose of the Clifton Health Department is to protect and promote the health of residents in the city through various programs and initiatives.
Information that must be reported to the Clifton Health Department may include but not limited to health inspections, infectious disease reports, and other health-related data.
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