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CHESAPEAKE HEALTH DEPARTMENT SCREENING INTAKE/REFERRAL FORM ****PLEASE COMPLETE AS MUCH AS POSSIBLE FAX TO ATTN: READMISSION SCREENING/FAX NUMBER: 7573828725****CLIENT INFORMATION NAME: DOB: CLIENT
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How to fill out chesapeake health department screening

01
To fill out the Chesapeake Health Department screening, follow these steps: 1. Visit the Chesapeake Health Department website
02
Locate the screening form on the website
03
Read the instructions and questions carefully
04
Provide accurate and truthful information in each field
05
Double-check your answers for any mistakes or missing information
06
Submit the completed screening form online or follow the designated submission process mentioned on the website
07
Wait for the confirmation or further instructions from the Health Department

Who needs chesapeake health department screening?

01
The Chesapeake Health Department screening is typically required for individuals who:
02
- Are experiencing COVID-19 symptoms
03
- Have been in close contact with a confirmed COVID-19 case
04
- Have traveled to high-risk areas
05
- Work in high-risk occupations such as healthcare or public services
06
- Have been advised or requested to get tested by a healthcare professional or local authorities

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