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DocuSign Envelope ID: 20143F53D9A64853B7EE626C17D89475HHSC CONTRACT NO. HHS000134700001 THE HEALTH AND HUMAN SERVICES COMMISSION (\”System Agency\”) and THE GULF COAST CENTER (\”Local Government\”),

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Form Health and Human is a document used for reporting health-related information and statistics to the relevant governmental health departments.

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Healthcare providers, organizations, and institutions that provide health-related services are typically required to file Form Health and Human.

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To fill out Form Health and Human, one must provide accurate information regarding their health services, patient statistics, and any other required health data as specified in the form instructions.

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The purpose of Form Health and Human is to collect data that helps in monitoring public health trends, implementing health policies, and ensuring compliance with health regulations.

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Information typically required includes patient demographics, service types, health outcomes, and any public health initiatives undertaken.

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