Department of Public Health Forms and Office Locations – Government Agency in Alabama

61 - 80 of 195 forms

Form Title	Topics
Complaint Form	EMS, EMS
Confirmed Tuberculosis Cases in Madison and Alabama Counties	Madison County
Construction Maintenance and Operation of Hotel Rules	Madison County
Contract Document Checklist	ABCCEDP, ABCCEDP
Cover Your Cough! Poster	Madison County
Criminal History Information Release Form	EMS, EMS
Critical Care Paramedic Application	EMS, EMS
Critical Care Provider Application	EMS, EMS
Cumulative Occupational Exposure History	Radiation
Declaration of Business Ownership Structure	Radiation
Declaration of Business Ownership Structure	EMS, EMS
Declaration of U.S. Citizenship or Lawful Presence of an Alien	Radiation
Declaration of U.S. Citizenship or Lawful Presence of an Alien	EMS, EMS
Designates an Authorized Agent to sign on behalf of the Responsible Person	Soils and Onsite Sewage
Disclosure Statement	ABCCEDP, ABCCEDP
Disposition of Radioactive Material (Documentation of Proper Transfer or Disposal	Radiation
E-HIPAA Log	Compliance And Ethics
Eligibility Criteria	ABCCEDP, ABCCEDP
Emergency Medical Services for Medical Needs Shelter Operation	Madison County
EMS Individual Licensure Application	EMS, EMS

All 2 contact points

Address:
201 Monroe Street
The RSA Tower
Montgomery, AL 36104

Phone numbers:

EAST CENTRAL DISTRICT

Address:
219 N. Court St
Prattville, AL 36067

Phone numbers:

Fax numbers:

Department of Public Health