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Agent Training Request, F-02524 (07/2019)

New Agent Details

Please complete the following form to alert the Department of Health Services (DHS) that a new Conditional Release, OARS, or Supervised Release agent has started. This form will initiate the DHS agent training. Thank you.
This question requires a valid date format of MM/DD/YYYY.
This question requires a valid email address.
8. Programs Working In