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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 SFN59322
for the current year.
Form SFN59322 Childhood Lead Poisoning Evaluation Questionnaire - North Dakota
What Is Form SFN59322?
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 the Form SFN59322?A: The Form SFN59322 is the Childhood Lead PoisoningEvaluation Questionnaire specifically designed for North Dakota.
Q: What is childhood lead poisoning?A: Childhood lead poisoning is a condition that occurs when a child has a high level of lead in their blood, which can cause serious health problems.
Q: What is the purpose of the questionnaire?A: The purpose of the questionnaire is to gather information about a child's exposure to lead and their risk of lead poisoning.
Q: Who should fill out the questionnaire?A: The questionnaire should be filled out by the child's parent or guardian with the assistance of a healthcare provider.
Q: What information is required in the questionnaire?A: The questionnaire requires information about the child's living environment, potential sources of lead exposure, and any symptoms or health concerns related to lead poisoning.
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 SFN59322 by clicking the link below or browse more documents and templates provided by the North Dakota Department of Environmental Quality.
