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Protecting and promoting quality of life through education, leadership, prevention and response.
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Home
About Us
Bid Notices
Blog & Recent News
Careers
Contact Us
JCHD Board of Trustees
New Hillsboro Facility Updates
Reports
Services
Community Health
Dental
Environmental
Mobile Health Center
Nursing
Nutrition
Public Health Preparedness
Vector Control
Vital Records
Health Topics
#kNOwLEAD
Respiratory Illnesses
Sexually Transmitted Infections
Stop Hepatitis A
Substance Use
Vaping
Resources
Community Resources
Breastfeeding Resources
How do I...?
Project Lifesaver Request Registration Form
Participant Name
*
First Name
Last Name
Parent/Guardian/Responsible Party Name
*
First Name
Last Name
Relationship to Participant
*
Phone Number of Parent/Guardian/Responsible Party
*
(###)
###
####
Reason inquiring about the program
Does the potential participant drive?
Yes
No
Does the potential participant live alone?
Yes
No
Thank you! Our coordinator will be reaching out to you soon.