Client Forms

EHP uses three screening and assessment forms to evaluate clients’ environmental conditions and health concerns. Healthcare providers are welcome to use any of EHP’s forms as needed in their own offices.

Our forms are also available in Spanish:

For additional resources, please see our Medical Toolbox page. Please direct any questions to jchabeau [at] environmentalhealthproject.org or 724-260-5504.

Photo by Bob Donnan. Drilling pad, PA. 2014. Provided by The FracTracker Alliance on FracTracker.org.