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CA ABP 1676-1 - Los Angeles County 2020-2025 free printable template

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Page 1 of 2Los Angeles County Department of Public Social Services Physical Health Assessment for General ReliefMediCal Status: No Medical Pending Medicate: Case Name: Case Number: District Name:
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Obtain the CA ABP 1676-1 form from the Los Angeles County official website or designated office.
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Residents of Los Angeles County who need to document their eligibility for support programs.
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CA ABP 1676-1 is a form used in Los Angeles County for reporting specific data related to public safety and health assessments.
Individuals or organizations involved in specific activities that impact public safety and health in Los Angeles County are required to file CA ABP 1676-1.
To fill out CA ABP 1676-1, provide accurate information regarding the activities and impacts, ensuring all sections are completed and signed where required.
The purpose of CA ABP 1676-1 is to collect information that helps local authorities assess and enhance public safety and health measures in the community.
The form requires reporting details such as entity names, contact information, nature of activities, and any relevant safety or health impacts associated with those activities.
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