And Underserved Populations 2025

Get Form
and Underserved Populations Preview on Page 1

Here's how it works

01. Edit your form online
Type text, add images, blackout confidential details, add comments, highlights and more.
02. Sign it in a few clicks
Draw your signature, type it, upload its image, or use your mobile device as a signature pad.
03. Share your form with others
Send it via email, link, or fax. You can also download it, export it or print it out.

How to Use or Fill Out the Registration Form for Underserved Populations

Form edit decoration
9.5
Ease of Setup
DocHub User Ratings on G2
9.0
Ease of Use
DocHub User Ratings on G2
  1. Click ‘Get Form’ to open it in our editor.
  2. Begin by selecting your registration fee. Options include $150, $100, or $50. For seniors and students, choose from the discounted rates of $75 or $25.
  3. Next, fill in your personal details. Print your name, title/affiliation, address, city/state/zip code, work phone, and email address clearly in the designated fields.
  4. If you wish to participate in the Healthy Lifestyles Marathon for Cancer Awareness and Prevention, check the corresponding box and include the special event fee of $25.
  5. Review all entered information for accuracy before submitting. Ensure that all required fields are completed.

Start filling out your form today on our platform for free!

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.
Contact us
Use people with lower incomes, people/households with incomes below the federal poverty level, people experiencing poverty, instead of poverty-stricken, the poor, or poor people. Do not use underserved when meaning low socioeconomic status.
A town or municipality with a majority of its population under the poverty line, or struggling with opportunity or access to affordable housing, educational opportunities, jobs, food, and other quality of life factors.
Underserved groups refer to populations that do not have adequate access to medical care. This includes rural, elderly, low-literacy, blue collar, and poor populations.
(39) Underserved populations The term underserved populations means populations who face barriers in accessing and using victim services, and includes populations underserved because of geographic location, religion, sexual orientation, gender identity, underserved racial and ethnic populations, populations
The US Department of Health and Human Services defines underserved populations as those with limited access to health care, whereas vulnerable individuals tend to experience additional barriers to getting care.
be ready to get more

Complete this form in 5 minutes or less

Get form