Form - HD-010 Referral rev 1/20 Printed black, one sided, 2 part NCR, 8.5x11, pack in 250s and 5 more items

The Florida Department of Health awarded a contract (EP490517) on November 17, 2025, with a completion date of February 28, 2026, for the procurement of specialized medical forms. The contract, valued at $2,034.50, involves the production of two distinct form types: HD-010 Referral and HD-211-EU Non-Maternity Encounter Form, both printed as two-part carbonless (NCR) documents.

The line items specify multiple orders of these forms, including 4 units of the HD-010 Referral form (priced at $128 per unit) and 10 units of the HD-211-EU Non-Maternity Encounter Form (priced at $152.25 per unit). Both form types are to be printed in black, single or double-sided, on 8.5x11 inch paper, with specific formatting requirements such as 2-hole punch and packaging in sets of 250. The forms appear to be used for healthcare documentation and encounter tracking within the Florida Department of Health's operational infrastructure.