____________________________________________________________________ Local Health Department Name 151 Family Planning Activity Number and Title Outreach and recruitment activities which target the at-risk population. $ Please describe briefly: Out-stationing of public health personnel at local DSS sites to facilitate the $ recruitment and provision of services to the at-risk population. Out-stationing DSS staff within family planning program sites to facilitate $ recruitment of the at-risk population. Other non-clinical services to the at-risk population. $ Please explain: Total of lines 1 through 6: $ Signature of Social Services Director or Authorized Representative Date Signature of Local Health Director or Authorized Representative Date
____________________________________________________________________ Local Health Department Name 151 Family Planning Activity Number and Title Outreach and recruitment activities which target the at-risk population. Please describe briefly: $ Out-stationing of public health personnel at local DSS sites to facilitate the recruitment and provision of services to the at-risk population. $ Out-stationing DSS staff within family planning program sites to facilitate recruitment of the at-risk population. $ Other non-clinical services to the at-risk population. Please explain: $ Total of lines 1 through 6: $ Signature of Social Services Director or Authorized Representative Date Signature of Local Health Director or Authorized Representative Date