Contact Personnel. The OSDH liaison for this Agreement is: Name: Avy Xxxxx Phone: (000) 000-0000 Email: XxxX@xxxxxx.xx.xxx The Receiving Agency liaison for this Agreement is: Name: Phone: Email: Name of Receiving Agency: Date: Signature: Name: Title: Oklahoma State Department of Health Date: Signature: Name: Xxxxx Xxxxxxxx, DrPH
Appears in 4 contracts
Samples: Memorandum of Agreement, Memorandum of Agreement, Memorandum of Agreement
Contact Personnel. The OSDH liaison for this Agreement is: Name: Avy Xxxxx Phone: (000) 000-0000 Email: XxxX@xxxxxx.xx.xxx The Receiving Agency liaison for this Agreement is: Name: Phone: Email: Name of Receiving Agency: Date: Signature: Name: Title: Oklahoma State Department of Health Date: Signature: Name: Xxxxx Xxxxxxxx, DrPHDrPH Title: Director, Injury Prevention Service, OSDH Treatment Priorities
Appears in 3 contracts
Samples: Memorandum of Agreement, Memorandum of Agreement, Memorandum of Agreement
Contact Personnel. The OSDH liaison for this Agreement is: Name: Avy Xxxxx Phone: (000) 000-0000 Email: XxxX@xxxxxx.xx.xxx The Receiving Agency liaison for this Agreement is: Name: Phone: Email: Name of Receiving Agency: Date: Signature: Name: Title: Oklahoma State Department of Health Date: Signature: Name: Xxxxx Xxxxxxxx, DrPHDrPH Title: Director, Injury Prevention Service, OSDH Attachment A Effective January 1, 2015 State of Oklahoma Treatment Priorities
Appears in 1 contract
Samples: Memorandum of Agreement