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Fluoride Monitoring & Reporting Forms

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Overview & Background Information

Open PDF file, 505.62 KB,  Community Water Fluoridation Information for Water Operators (English, PDF 505.62 KB)
Open DOCX file, 1.37 MB,  Community Water Fluoridation Information for Water Operators (English, DOCX 1.37 MB)
Open PDF file, 24.87 KB,  Cover Letter for Updated Fluoridation Monitoring & Reporting Forms (English, PDF 24.87 KB)
Fact Sheet: Increasing Color in Some Fluorosilicic Acid Products 

Daily Reporting Forms

Open PDF file, 14.56 KB,  Massachusetts Department of Public Health Daily Fluoridation Report Instructions (English, PDF 14.56 KB)
Open PDF file, 11.06 KB,  Fluoride Dosage Calculations for use with Mass. Department of Public Health Daily Fluoridation Report (English, PDF 11.06 KB)
Open PDF file, 16.44 KB,  Fluoride Daily Reporting Form (English, PDF 16.44 KB)
Open DOC file, 140.5 KB,  Fluoride Daily Reporting Form (English, DOC 140.5 KB)

Daily Reporting Forms for Fluoridation Compounds

Open PDF file, 9.38 KB,  Instructions for Fluoride Reporting (English, PDF 9.38 KB)
Open PDF file, 16.96 KB,  Sodium Fluoride by Cubic Feet Reporting Form (English, PDF 16.96 KB)
Open XLS file, 51 KB,  Sodium Fluoride by Cubic Feet Reporting Form (MS Excel) (English, XLS 51 KB)
Open PDF file, 16.96 KB,  Sodium Fluoride by Gallons Reporting Form (English, PDF 16.96 KB)
Open XLS file, 50 KB,  Sodium Fluoride by Gallons Reporting Form (MS Excel) (English, XLS 50 KB)
Open PDF file, 16.69 KB,  Hydrofluorosilicic Acid Reporting Form (English, PDF 16.69 KB)
Open XLS file, 48.5 KB,  Hydrofluorosilicic Acid Reporting Form (MS Excel) (English, XLS 48.5 KB)
Open PDF file, 16.66 KB,  Sodium Silicofluoride Reporting Form (English, PDF 16.66 KB)
Open XLS file, 40.5 KB,  Sodium Silicofluoride Reporting Form (MS Excel) (English, XLS 40.5 KB)

Weekly Reporting Form

Open PDF file, 9.58 KB,  Massachusetts Department of Public Health Weekly Fluoridation Report Instructions (English, PDF 9.58 KB)
Open DOC file, 113.5 KB,  Fluoride Weekly Reporting Form (English, DOC 113.5 KB)
Open PDF file, 23.33 KB,  Fluoride Weekly Reporting Form (English, PDF 23.33 KB)

Monthly Reporting Form

Open PDF file, 7.91 KB,  Massachusetts Department of Public Health Monthly Fluoridation Report Instructions (English, PDF 7.91 KB)
Open DOC file, 66 KB,  Fluoride Monthly Reporting Form (English, DOC 66 KB)
Open PDF file, 18.77 KB,  Fluoride Monthly Reporting Form (English, PDF 18.77 KB)

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