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EnvironmentalHealth Referral FormExplanation for the Patient: This Referral is for you to request the Environmental Health (EH) Team to visit you at your home. This visit is voluntary. When you sign
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Fill in the required personal information, such as name, contact details, and relevant identification
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The kahpf-environmental-health-sub-committeeenvironmental-health-referral-form-oct18docx is needed by individuals or organizations who require assistance or intervention from the Environmental Health Sub-Committee. This may include individuals experiencing health issues related to environmental factors, organizations seeking the committee's guidance or action on specific environmental concerns, or any party with a legitimate need to involve the sub-committee in addressing environmental health matters.
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The kahpf-environmental-health-sub-committeeenvironmental-health-referral-form-oct18docx is a document utilized for referring cases to the Environmental Health Sub-Committee for review and action, aiming to address public health concerns.
Individuals or entities that identify potential environmental health issues and require intervention or review from the Environmental Health Sub-Committee are required to file this referral form.
To fill out the form, begin by providing basic information about the referral, including the name and contact details of the person filing, a detailed description of the environmental health concern, and any supporting evidence or documentation required.
The purpose of the referral form is to formally document and report environmental health concerns so that they can be assessed and addressed by the qualified members of the Environmental Health Sub-Committee.
The form requires information such as the referrer's contact details, description of the environmental health issue, location of the concern, date of occurrence, and any other relevant documentation or evidence supporting the referral.
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