Instructions: Please enter the requested staff information in the form below. The Department of State Health Services (DSHS) requests that this information is provided daily. The form should be completed by noon each day (including weekends and holidays). Please include all onboarded staff assigned to your facility - whether the staff is on duty or not. When you hit "Submit", the form will be sent directly to the region 7 Regional Medical Operations Center (7-RMOC). Thank you!

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