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Protecting, MaintainingandImprovingtheHealthofAllMinnesotans Electronically delivered October23,2020 Administrator ChrisJensenHealth&RehabilitationCenter 2501RiceLakeRoad Duluth,MN55811 RE: CCN:245366

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How to fill out actat1819f2biiiiband1919f2biiiibwenotifiedyouthatyourfacilityisprohibitedfrom

01

Obtain the ACTAT1819F2BIII form from the appropriate authority.

02

Fill out all required fields on the form accurately and completely.

03

Clearly indicate on the form that your facility has been notified that it is prohibited from certain activities.

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Submit the completed form to the relevant authorities within the specified timeframe.

Who needs actat1819f2biiiiband1919f2biiiibwenotifiedyouthatyourfacilityisprohibitedfrom?

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Any facility or organization that has been notified that it is prohibited from certain activities needs to fill out the ACTAT1819F2BIII form.

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What is actat1819f2biiiiband1919f2biiiibwenotifiedyouthatyourfacilityisprohibitedfrom?

The act prohibits access to the facility.

Who is required to file actat1819f2biiiiband1919f2biiiibwenotifiedyouthatyourfacilityisprohibitedfrom?

All facility administrators are required to file this.

How to fill out actat1819f2biiiiband1919f2biiiibwenotifiedyouthatyourfacilityisprohibitedfrom?

The form must be completed online.

What is the purpose of actat1819f2biiiiband1919f2biiiibwenotifiedyouthatyourfacilityisprohibitedfrom?

The act aims to protect the youth.

What information must be reported on actat1819f2biiiiband1919f2biiiibwenotifiedyouthatyourfacilityisprohibitedfrom?

Any incidents involving youth access.

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