1. Reporter details

Per 7 AAC 27.013, health care providers are required to report all injuries caused by a firearm to the Division of Public Health. Reports must be made within 5 working days of the date of diagnosis. Forms and definitions may be found at http://dhss.alaska.gov/dph/Epi/Pages/pubs/conditions/crforms.aspx.

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* Reporting Agency

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* Agency phone number

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* Agency record number

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14% of survey complete.

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