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FAX Page 1 To: Benton Franklin Health District 5094604377 (Confidential FAX Line)Adapted from WA DOH Form 347102CONFIDENTIAL SEXUALLY TRANSMITTED DISEASE CASE REPORT STDs within three work days (WAC

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How to fill out WA DOH 347-102 - Benton-Frankliny

1. Obtain the WA DOH 347-102 - Benton-Frankliny form from the Washington State Department of Health website or local health department.
2. Read the instructions carefully to understand the required information.
3. Fill in your personal details such as name, address, and contact information.
4. Provide any relevant health information as requested on the form.
5. Make sure to check the accuracy of the information you have provided.
6. Sign and date the form where indicated.
7. Submit the completed form to the appropriate department as specified in the instructions.

Who needs WA DOH 347-102 - Benton-Frankliny?

1. Individuals residing in Benton and Franklin counties who are seeking public health services.
2. Healthcare providers who need to report health-related data.
3. Businesses that are required to comply with public health regulations.
4. Organizations or entities involved in health research or community health assessments.

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What is WA DOH 347-102 - Benton-Frankliny?

WA DOH 347-102 - Benton-Frankliny is a specific form issued by the Washington State Department of Health for reporting health-related data concerning Benton and Franklin counties.

Who is required to file WA DOH 347-102 - Benton-Frankliny?

Entities such as healthcare providers, hospitals, and public health officials in Benton and Franklin counties are required to file WA DOH 347-102.

How to fill out WA DOH 347-102 - Benton-Frankliny?

To fill out WA DOH 347-102, users must complete the required sections with accurate data, ensuring all fields are filled according to the guidelines provided by the Washington State Department of Health.

What is the purpose of WA DOH 347-102 - Benton-Frankliny?

The purpose of WA DOH 347-102 is to collect and report health data to monitor public health trends and ensure compliance with health regulations in Benton and Franklin counties.

What information must be reported on WA DOH 347-102 - Benton-Frankliny?

Information that must be reported includes patient demographics, health conditions, treatment details, and any relevant public health concerns or outbreaks.