Resources

Forms, Logs

• Rice Acidification
• Shellfish Daily Sanitation
• Shellfish Daily Sanitation
• Shellfish Refrigeration
• Thermometer Accuracy - pdf
• Thermometer Calibration
• Time Temperature Cooling Graph Sample
• Weekly Cooler Temperature Monitoring - pdf

Forms

• RIDOH CHW Program Contact & Information Form
• RIDOH State Health Laboratories Test Requisition
• Ryan White HIV/AIDS Program AIDS Drug Assistance Program (ADAP) and RI-Federally Assisted Benefit Program (RI-FAB)
• School Data Release to KIDSNET (Spanish) (Cape Verdean Creole)
• Seasonal Start-Up Form
• Sickle Cell Request Form
• Source Well Data Form
• Special Needs Emergency Registry (English)
• Special Needs Emergency Registry (Spanish)
• State Medical Examiner Decedent Release Authorization
• Temporary Event Sponsor Form
• Temporary Event Vendor List
• Time/Temperature Cooling Graph
• Training in Glucagon Administration for Volunteers in Schools Certification (2005)
• Transient Public Water System Emergency Response Plan
• Voluntary Adoption Reunion Registry Medical History Form
• Water Quality Parameter Daily Operations Logs
• WIC Vendor Complaint
• WIC Vendor Product Approval Form

Forms, Consent

• Sample for Treatment with Opioids for Non-Cancer related Chronic Pain
• WISEWOMAN Informed Consent for Medicaid Recipients (Spanish)

Forms, Agreement

• Sample Patient - Provider Agreement for Opioid Treatment

Forms, Screening

• School Dental (Spanish) (Portuguese)

Forms, Medical

• School Physical

Forms, Reporting

• Self-Reporting Incident
• Synthetic Organic Compounds
• Tickborne Rickettsial Case Report Form
• Traumatic Brain Injury Registry Form
• Trihalomethanes
• Tuberculosis
• Volatile Organic Compounds

Forms, Assessment

• Senior Resiliency Facility Self-Assessment Tool
• Six Month Health and Visual Assessment

Forms, Enrollment

• State-Supplied Vaccine (SSV) Program Enrollment Form
• Women's Cancer Screening Program / WISEWOMAN Program (Spanish)

Forms, Applications

• Supervising Shop Manager

Forms, Status

• Tax Payer Affidavit

Forms, Worksheet

• Temperature Excursion Response Worksheet
• Understanding Your Private Well Lab Report

Forms, Log

• Temperature for Adult Vaccines Fahrenheit (2014)

Forms, Referral

• Tuberculosis Referral
• WISEWOMAN/Community Health Network Program Referral

Forms, Plan

• Vaccine Storage Emergency Preparedness Plan

• AIS Requirements
• Build America, Buy America Requirements
• Davis-Bacon Prevailing Wage Requirements
• DBE Good Faith Efforts
• DBE Subcontractor Participation Form
• DBE Subcontractor Performance Form
• DBE Subcontractor Utilization Form
• Debarment and Suspension
• EPA Memo: Prohibition on Certain Telecommunication and Video Surveillance
• MBE Project Reporting Form
• Relevant Federal and State Laws
• Rhode Island MBE Utilization Plan Form
• SRF Signage Specifications
• SRF Signage Specifications - Bipartisan Infrastructure Law

SRF Project Approval Process and Guidance

• DWSRF Program Application for Certificate of Approval
• Request for Categorical Exclusion Template and Guidance

Instructions, Manuals, Procedures

• 1 Year Private Well Test Kit Instructions
• 3-5 Year Private Well Test Kit Instructions
• 5-10 Year Private Well Test Kit Instructions
• Ambulance Licensure and Inspection
• Application for Registration by Examination
• Beach Sample Collection Procedures
• Buccal Swab Collection Instructions
• Cannabis Licensing Portal User Guide