Form - HD-211-OB, rev date Front 11-21, Back 7/19 MATERNITY ENCOUNTER Form, Printed on, 2 part… and 2 more items

The Florida Department of Health awarded a contract valued at $1,871.00 with an award date of February 24, 2026, and completion date of May 31, 2026. The contract calls for the delivery of specialized medical encounter and resource forms to support maternal and community health programs. The primary deliverables include eight units of HD-211-OB Maternity Encounter Forms and five units of HD-211-U Non-Maternity Forms, each priced at $127 per unit. Both forms are two-part carbonless (NCR) documents printed in black ink on white and yellow stock, measuring 8.5 by 11 inches with two-hole top center configuration, two-sided printing, and packed in quantities of 250 forms per unit.

In addition to the maternity and non-maternity encounter forms, the contract includes two units of HD 415 E-M Community Resources Forms in English, priced at $110 per unit. These forms are also two-part carbonless documents with similar specifications, including two-hole top center drilling and one-sided printing, packed in quantities of 250 forms per unit. The combined procurement of these three distinct form types totals approximately $1,871 and represents consumable supplies to support the Department of Health's clinical and community outreach operations throughout the stated performance period.