Get the free Health Impact Review Request Form - Washington State Board of ... - sboh wa

Health Impact Review Request Form Date of request: 1 / 27 / 14 Requesters: Senator Lii as Note: Health impact reviews may only be requested by the Governor or a legislator. Staff Contact: Name: Phone:

How to fill out health impact review request

Who needs health impact review request?

Organizations or individuals planning to undertake a development project that may have potential health impacts on the community or population.

How to fill out health impact review request?

1. Start by obtaining the official health impact review request form. This form is usually available on the website of the relevant health department or local authority responsible for overseeing such reviews.
2. Provide all the necessary personal or organizational information as required on the form. This may include your name, contact details, address, and any other relevant identification information.
3. Clearly state the nature of the development project for which you are seeking a health impact review. Include details such as the location, purpose, and scale of the project.
4. Describe the potential health impacts that the project may have on the community or population. This could involve issues such as air or water pollution, noise disturbances, increased traffic, disruption of public services, or any other factors that could affect the health and well-being of individuals.
5. If available, include any supporting documentation or data that can help assess the potential health impacts. This may include environmental impact reports, health risk assessments, or any studies conducted to determine the likely consequences on public health.
6. Clearly communicate your concerns, suggestions, or requirements regarding the health impact review process. This could involve requesting specific mitigation measures to minimize or control potential health risks, proposing alternatives, or seeking clarification on specific aspects of the review process.
7. If necessary, provide any additional information or comments that could assist the reviewing authority in making an informed decision. This could include any relevant expertise or experience you or your organization possess, as well as any community or stakeholder input.
8. Carefully review the completed form for accuracy and completeness. Ensure that all required fields are properly filled and that the information provided is clear and concise.
9. Submit the health impact review request form to the designated authority or department as specified in the instructions. This may involve mailing the form, submitting it online, or delivering it in person to the relevant office.
10. Keep a copy of the completed form for your records, along with any supporting documentation. This will be useful for reference purposes and can serve as evidence of your efforts to address potential health impacts during the development process.

For pdfFiller’s FAQs

What is health impact review request?

A health impact review request is a formal application submitted to assess the potential impact of a project or development on public health.

Who is required to file health impact review request?

Any individual, organization, or government agency planning a project or development that may have an impact on public health is required to file a health impact review request.

How to fill out health impact review request?

To fill out a health impact review request, one must provide detailed information about the project or development, potential health impacts, and mitigation measures.

What is the purpose of health impact review request?

The purpose of a health impact review request is to evaluate and address any potential risks or concerns related to public health before a project or development is approved.

What information must be reported on health impact review request?

Information such as project details, potential health impacts, mitigation measures, and any relevant data or studies must be reported on a health impact review request.

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