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  • 2010 - 04.01


    Resource Request Form

    Consent Form*

    Authorization for Release of Medical Information

    Acknowledgment of Receipt of Privacy Practices*

    Notice of Privacy Practices (No need to print – just to read)

    JMP Info-Sheet

    CDBG Form*

    *NOTE about ECHS Walk-Through Registration: The forms that have a * will be collected during ECHS Walk-Through Registration. If you’d like to print them and fill them out in advance, you can save time at Walk Through Registration. The printed forms will also be available during ECHS Registration, so you can pick them up there if you prefer.