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This version of the form is not currently in use and is provided for reference only. Download this version of
Form SFN60104
for the current year.
Form SFN60104 Blood Lead Report - North Dakota
What Is Form SFN60104?
This is a legal form that was released by the North Dakota Department of Environmental Quality - a government authority operating within North Dakota. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form SFN60104?
A: Form SFN60104 is the Blood Lead Report for North Dakota.
Q: Who needs to fill out Form SFN60104?
A: Healthcare providers and laboratories are required to fill out Form SFN60104.
Q: What information is required on Form SFN60104?
A: Form SFN60104 requires information such as patient demographics, blood lead levels, and medical provider information.
Q: When is Form SFN60104 due?
A: Form SFN60104 should be submitted within 30 days of testing.
Q: Why is Form SFN60104 important?
A: Form SFN60104 helps the North Dakota Department of Health monitor and address cases of elevated blood lead levels in the state.
Q: Are there any fees associated with Form SFN60104?
A: No, there are no fees associated with Form SFN60104.
Q: What if I have questions about Form SFN60104?
A: If you have questions about Form SFN60104, you can contact the North Dakota Department of Health for assistance.
Form Details:
- Released on March 1, 2019;
- The latest edition provided by the North Dakota Department of Environmental Quality;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of Form SFN60104 by clicking the link below or browse more documents and templates provided by the North Dakota Department of Environmental Quality.
