WA DOH 347-102 - Jefferson County 2019 free printable template
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Jefferson County Public Health
3603853878 (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 - Jefferson County
How to fill out WA DOH 347-102 - Jefferson County
01
Obtain WA DOH 347-102 form from the Washington State Department of Health website or local health authority.
02
Read the instructions provided with the form to ensure understanding of the requirements.
03
Fill in the 'Applicant Information' section with your personal details such as name, address, and contact information.
04
Complete the 'Property Information' section by providing the necessary details about the property in Jefferson County.
05
Fill in any applicable sections regarding permits, inspections, and any required documentation.
06
Review all information for accuracy and completeness before submission.
07
Submit the form along with any necessary fees to the appropriate local health authority in Jefferson County.
Who needs WA DOH 347-102 - Jefferson County?
01
Individuals or property owners seeking to obtain permits or approvals related to wastewater disposal systems or other environmental health concerns in Jefferson County.
02
Contractors or businesses involved in construction or renovation that requires adherence to health regulations regarding wastewater in Jefferson County.
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What is WA DOH 347-102 - Jefferson County?
WA DOH 347-102 is a specific reporting form used by healthcare providers in Jefferson County, Washington, primarily for the collection of data related to public health initiatives and reporting of communicable diseases.
Who is required to file WA DOH 347-102 - Jefferson County?
Healthcare providers, including hospitals, clinics, and individual practitioners in Jefferson County, are required to file WA DOH 347-102 whenever they diagnose or treat certain communicable diseases or health conditions that need to be reported to public health authorities.
How to fill out WA DOH 347-102 - Jefferson County?
To fill out WA DOH 347-102, providers should carefully review the instructions included with the form, provide accurate patient information, document the diagnosis, treatment, and any other required details clearly, and submit the completed form to the designated public health contact for Jefferson County.
What is the purpose of WA DOH 347-102 - Jefferson County?
The purpose of WA DOH 347-102 is to facilitate the monitoring and reporting of communicable diseases in Jefferson County, helping public health officials to track outbreaks, manage public health responses, and inform community health strategies.
What information must be reported on WA DOH 347-102 - Jefferson County?
The information that must be reported on WA DOH 347-102 includes patient demographics (such as name, date of birth, and contact information), the diagnosis made, the treatment provided, and other specifics as required by the state and local health authorities related to communicable diseases.
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