Agency Schedule Detail

Authorization Number : 440-0377

Agency Series No. : 39-06

Status : Active

Agency Web Link :

Agency : DOH

Confidential Description : N/A-Load

Division : DOH5000

Vital Description : N/A-Load

Section : DOH50005039

Record Title : Ryan White CARE Program Intake Form

Revision : 0

Record Description : Contains Client Data Intake Report which is completed by every patient participating in the Ryan White CARE Program. Includes a patient ID number, address, insurance information, physican information and other demographic information.

Retention Period	Retention Justification	Media Code	Method of Disposal
Retain for 10 years after destruction of hard copy, then destroy	Programtic needs of the agency. To plot trends and analyze data on the HIV virus.	Electronic	Erase
Retain for 10 years after destruction of hard copy, then destroy	Programtic needs of the agency. To plot trends and analyze data on the HIV virus.	Paper	Wastepaper

Approvals

Status	Name	Title	Date
Approved	Transfer User	Records Viewer	7/27/1992 12:00:00 AM

Notes

Date	Reason	User