Get the free PEBB FluMist Consent form 2014-2015 - public health oregon
Show details
This document is a consent form for administering the FluMist vaccine, requiring patient information and health history questions to determine eligibility for the vaccine.
We are not affiliated with any brand or entity on this form
Get, Create, Make and Sign pebb flumist consent form
Edit your pebb flumist consent form form online
Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.
Add your legally-binding signature
Draw or type your signature, upload a signature image, or capture it with your digital camera.
Share your form instantly
Email, fax, or share your pebb flumist consent form form via URL. You can also download, print, or export forms to your preferred cloud storage service.
Editing pebb flumist consent form online
Here are the steps you need to follow to get started with our professional PDF editor:
1
Set up an account. If you are a new user, click Start Free Trial and establish a profile.
2
Simply add a document. Select Add New from your Dashboard and import a file into the system by uploading it from your device or importing it via the cloud, online, or internal mail. Then click Begin editing.
3
Edit pebb flumist consent form. Text may be added and replaced, new objects can be included, pages can be rearranged, watermarks and page numbers can be added, and so on. When you're done editing, click Done and then go to the Documents tab to combine, divide, lock, or unlock the file.
4
Get your file. Select the name of your file in the docs list and choose your preferred exporting method. You can download it as a PDF, save it in another format, send it by email, or transfer it to the cloud.
With pdfFiller, it's always easy to work with documents. Try it!
Uncompromising security for your PDF editing and eSignature needs
Your private information is safe with pdfFiller. We employ end-to-end encryption, secure cloud storage, and advanced access control to protect your documents and maintain regulatory compliance.
How to fill out pebb flumist consent form
How to fill out PEBB FluMist Consent form 2014-2015
01
Obtain the PEBB FluMist Consent form for the 2014-2015 season.
02
Read the instructions on the form carefully.
03
Fill out the patient's personal information, including name, date of birth, and contact details.
04
Indicate any known allergies or medical conditions related to vaccines.
05
Sign and date the consent section to confirm understanding of the risks and benefits.
06
If applicable, include the name and contact information of the guardian or caregiver signing on behalf of a minor.
07
Review the completed form for accuracy and completeness.
08
Submit the form to the appropriate healthcare provider or organization as instructed.
Who needs PEBB FluMist Consent form 2014-2015?
01
Individuals eligible for the PEBB health plan who are seeking the FluMist vaccine.
02
Parents or guardians of dependents who want their children to receive the FluMist vaccine.
03
Employees of the PEBB program and their covered family members.
Fill
form
: Try Risk Free
People Also Ask about
What is the administration code for the influenza vaccine?
Medicare requires use of Healthcare Common Procedural Coding System (HCPCS) codes for the administration of the vaccines that they cover preventively, including influenza vaccine. HCPCS code G0008 must be used when billing Medicare for the administration of Fluzone and Fluzone High-Dose vaccine.
What year was the flu vaccine approved?
1945. The first flu vaccines are approved for use for people who aren't in the U.S. military.
How to code for flu vaccine administration?
Report codes 90471-90474 for immunization administration of any vaccine that is not accompanied by face-to-face physician or other qualified health care professional counseling the patient and/or family, or for patients over 18 years of age.
How do you document the administration of the flu vaccine?
Medical record: Record the date the vaccine was administered, the manufacturer and lot number, the vaccination site and route, and the name and address and, if appropriate, the title of the person administering the vaccine.
What is the ICD-10 code for flu vaccine administration?
ICD-10 code Z23 for Encounter for immunization is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .
What is the CDC vaccine information statement for the flu?
CDC recommends everyone 6 months and older get vaccinated every flu season. Children 6 months through 8 years of age may need 2 doses during a single flu season. Everyone else needs only 1 dose each flu season. It takes about 2 weeks for protection to develop after vaccination.
How to code flu vaccine?
CPT Codes for Flu Vaccines and Flu Vaccine Reimbursement Information Presentation. and Doseᵃ 10 single-dose. 0.5 mL prefilled. syringes. Vaccine CPTᵇ® Code. 90662. When the Payer Requires the. Outer Carton NDCᶜ 49281-124-65. When the Payer Requires the. Unit-of-Use NDC. 49281-124-88.
For pdfFiller’s FAQs
Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.
What is PEBB FluMist Consent form 2014-2015?
The PEBB FluMist Consent form 2014-2015 is a document that provides consent for the administration of the FluMist vaccine for the flu season specified.
Who is required to file PEBB FluMist Consent form 2014-2015?
Individuals eligible for the FluMist vaccine through the PEBB program are required to file the consent form, including members and their dependents who intend to receive the vaccine.
How to fill out PEBB FluMist Consent form 2014-2015?
To fill out the PEBB FluMist Consent form 2014-2015, you must provide personal information such as your name, date of birth, and contact information, followed by any medical history relevant to the vaccine, and sign to indicate consent.
What is the purpose of PEBB FluMist Consent form 2014-2015?
The purpose of the PEBB FluMist Consent form is to obtain permission from individuals to administer the FluMist vaccine, ensuring informed consent regarding the benefits and risks associated with the vaccine.
What information must be reported on PEBB FluMist Consent form 2014-2015?
The information that must be reported includes personal identification details, vaccination history, health status, and a signature confirming consent for the FluMist vaccine.
Fill out your pebb flumist consent form online with pdfFiller!
pdfFiller is an end-to-end solution for managing, creating, and editing documents and forms in the cloud. Save time and hassle by preparing your tax forms online.
Pebb Flumist Consent Form is not the form you're looking for?Search for another form here.
Relevant keywords
Related Forms
If you believe that this page should be taken down, please follow our DMCA take down process
here
.
This form may include fields for payment information. Data entered in these fields is not covered by PCI DSS compliance.
