EHP uses three screening and assessment forms to evaluate clients’ environmental conditions and health concerns. Healthcare providers are welcome to use any of EHP’s forms as needed in their own offices.
- Survey for Patients’ Potential Exposure
- Individual Health Exposure Assessment
- Home Exposure Assessment
Our forms are also available in Spanish:
- Evaluación de Exposición de Salud del Individuo
- Evaluación de Exposición del Hogar Relacionada con las Actividades de Perforación Petrolera y de Gas
For additional resources, please see our Medical Toolbox page. Please direct any questions to jchabeau [at] environmentalhealthproject.org or 724-260-5504.