Kentucky Department for Public Health Forms

This form is used for authorizing the disclosure of protected information in the state of Kentucky.

This form is used for notifying participants about a conference in Kentucky.

This form is used for requesting authorization to access electronic reports for the Women, Infants, and Children (WIC) program in Kentucky.

This document is used for reporting confidential HIV cases in adults in the state of Kentucky. It ensures privacy and helps track and manage HIV cases.

This document is used for employees in Kentucky to agree to protect the privacy and security of protected health, confidential, and sensitive information.

This form is used for requesting an appeal in the state of Kentucky. It is used to initiate the process of having a decision or ruling reconsidered.

This form is used for conducting an adult interval history and physical examination in the state of Kentucky. It includes thorough documentation of a patient's medical history and current condition.

This form is used for breast cancer screening in the state of Kentucky. It contains relevant information and questions to assess a person's risk and schedule necessary screenings.

This form is used for logging breast imaging and CBE (Clinical Breast Exam) in the state of Kentucky.

This Form is used for sending a second notice for ground rent payment in Kentucky.

This Form is used for administering and recording the Jynneos vaccine in Kentucky.

This document provides physicians with guidance and recommendations for providing end-of-life care to patients in Kentucky. It covers important considerations and options for ensuring comfort and support during this stage of life.

This form is used for requesting a Do Not Resuscitate (DNR) order for individuals under guardianship in the state of Kentucky.

This Form is used for applying for a license in Kentucky. It is the official application form that must be completed in order to obtain a license in the state.

This form is used for obtaining a business license surety bond in Kentucky. A business license surety bond is a type of financial guarantee that ensures a business will comply with all laws and regulations. It protects the state and consumers in the event that the business fails to fulfill their obligations. By completing this form, businesses can secure the necessary bond required to operate legally in Kentucky.

This form is used for reporting tuberculosis screening information to the Tuberculosis Control Program in Kentucky.

This form is used in Kentucky to record and provide detailed information about the birth of a child. It comprehensively covers data like the newborn's biological details, parent's information, and the circumstances surrounding the birth.

This document is used for requesting a certified copy of a marriage/divorce certificate in Kentucky.

This form is used for requesting a referral to the Kentucky WIC program, which provides food assistance for low-income women, infants, and children.

This document provides a comprehensive guide outlining the suggested timeline for different vaccines suggested by the health department for children of various age groups in Kentucky. This helps in keeping track of necessary immunizations for your child's health.