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2020 Pinal County Community Health Needs Assessment
ADHS | 2020 Pinal County Child Fatality Review
2020 Pinal County Community Health Improvement Plan
Public Health Annual Report FY20-21
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Client Rights and Responsibilities - English
Client Rights and Responsibilities - Spanish
Privacy Compliance Complaint Form - English
Privacy Compliance Complaint Form - Spanish
Protected Health Information Access Request - English
Protected Health Information Access Request - Spanish
Protected Health Information Amendment Request - English
Protected Health Information Amendment Request - Spanish
Request for Alternative Communications - English
Request for Alternative Communications - Spanish
Request for Content and Accounting of Disclosures of Protected Health Information - English
Request for Content and Accounting of Disclosures of Protected Health Information - Spanish
Request for Restriction of Use and Disclosure of Protected Health Information - English
Request for Restriction of Use and Disclosure of Protected Health Information - Spanish
Acknowledgement of Receipt of Notice of Privacy Practices & Client Rights and Responsibilities - English
Acknowledgement of Receipt of Notice of Privacy Practices & Client Rights and Responsibilities - Spanish
HIPAA Authorization to Release Medical Information
(Hidden) Medical Release Forms
Medical Release Form
ROI to Outside Agency - English
ROI to Outside Agency - Spanish
(Hidden) Oral Contraceptives Pills Consents/Instructions
Combination Oral Contraceptives Consent - English
Combination Oral Contraceptives Consent - Spanish
Combination Oral Contraceptives Instructions - English
Combination Oral Contraceptives Instructions - Spanish
POP Consent - English
POP Consent - Spanish
POP Instruction - English
POP Instruction - Spanish
(Hidden) Depo Consents
Depo Consent - English
Depo Consent - Spanish
(Hidden) Emergency Contraceptive Pill (ECP) Consents
ECP Consent - English
ECP Consent - Spanish
(Hidden) Clinic Registration Forms
New Patient Registration Form (English)
New Patient Registration Form (Spanish)
Immunization Registration Form (English/Spanish)
Annual Reports
PCPHSD 2018 CHIP Final Report
PCPHSD 2018 CHNA Final Report
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