COMMUNITY HEALTH
C-O-N-N-E-C-T-I-O-N-S
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Downloadable Fact Sheets, Manuals & Forms
Fact sheets and manuals are in pdf format.
Click button below to download FREE Adobe Reader...
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Medication Administration Student Testing Course Requirements |
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Red Cross Emergency Planning Guide For Special Care Facilities |
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Form Name |
Format* |
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Intensive Technical Assistance Request Form |
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Health Care Representative Form |
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Individualized Feeding Plan Form |
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Lifetime Medical History Form |
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* All of our downloadable forms are available in two different formats:
MS Word format is a "fill-in-the-blanks" form that allows the user to complete the form on their computer and print or email.
PDF format allows the user to print a blank form to be completed by hand. Need Adobe Reader? Click button below!
To Use Intensive TA Request Form
Fill out form and send by e-mail:
Click on MS Word version of the form.
You will see the following dialog box:
Click on Save to save the document to your computer.
Fill-out required information.
Save completed document to your computer.
To e-mail, click on File, then Send To, then Mail Recipeint (as attachment)
Send to info@hcqu.org
Print form and send by fax or mail:
Click on PDF version of form. You will see the following dialog box:
Click on Open.
Print Form and complete by hand.
Fax to (724) 283-1012 OR
Mail to:
Community Health Connections
120 Hollywood Drive, Suite 201
Butler PA 16001
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Community Health
Connections |
724.283.0990 |