STATE OF MARYLAND
STATE OF MARYLAND
DHMH
Maryland Department of Health and Mental Hygiene
201 W. Preston Street • Baltimore, Maryland 21201
Martin O’Malley, Governor – Anthony G. Brown, Lt. Governor -- Joshua M. Sharfstein, M.D., Secretary
Family Health Administration
Donna Gugel, Acting Director
CCSC HOM #12-20
MEMORANDUM
To: Health Officers
CRF/CPEST Program Directors, Coordinators, and Staff
SAHC Program Directors, Coordinators, and Staff
From: Barbara Andrews
Program Manager, Cigarette Restitution Fund Programs Unit, CCSC
Date: May 11, 2011
Subject: Spanish Translation of the CRF CPEST Consent Form
______________________________________________________________________________
As requested, we have obtained a Spanish translation of the Long Form Consent for the Cigarette Restitution Fund (CRF), Cancer Prevention, Education, Screening, and Treatment (CPEST) Program. See attached. This document can be modified for your program to be consistent with your programs offering colorectal, prostate, skin, and/or oral cancer screening. This translation is consistent with the consent in English that we provided in Health Officer Memo #11-42, November 21, 2011.
Additionally, attached is the Breast and Cervical Cancer Program Spanish consent. This form is also available on the BCCP website at .
If you have any questions, please feel free to contact me at 410-767-5123 or bandrews@dhmh.state.md.us
Attachments (e-mailed to Health Officers and CRF Coordinators)
cc: Donna Gugel, Kelly Sage
Courtney Lewis, Sarah Hokenmaier
Diane Dwyer, M.D., Carmela Groves
File
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