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STAFF USE ? CT State Clinic Site: Verified by: Flu Prevention Program CONNECTICUT STATE CLINICS 2013 ADULT INFLUENZA IMMUNIZATION CONSENT Patient Name Gender (As it appears on insurance card) M Date
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What is ct state clinic?
The CT State Clinic is a healthcare facility operated by the state of Connecticut to provide medical services to residents.
Who is required to file ct state clinic?
All healthcare facilities operating in the state of Connecticut are required to file the CT State Clinic report.
How to fill out ct state clinic?
The CT State Clinic report can be filled out online through the official state website or through a paper form that can be mailed in.
What is the purpose of ct state clinic?
The purpose of the CT State Clinic report is to gather information on healthcare services provided in the state of Connecticut for monitoring and improvement purposes.
What information must be reported on ct state clinic?
The CT State Clinic report must include information on the types of medical services offered, number of patients served, and any significant medical events that occurred.
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