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Office use only Date Sent Sent By Completed By Date Received TRAVEL IMMUNIZATION WORKSHEET Clallam County Department of Health Human Services th Mailing Address 223 East 4 Street Suite 14 Port Angeles WA 98362-3015 rd Physical Address 111 East 3 Street Suite 1A Port Angeles WA 98362 360-417-2274 FAX 360-452-4492 Received By Receipt Amt Please Complete the Top Portion of this Form and Mail with 50 Check or Money Order per Traveler Out Of Clallam County Residents 75 Check or Money Order per...
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What is immunization worksheet?
Immunization worksheet is a document used to track and report immunization records for individuals.
Who is required to file immunization worksheet?
Healthcare providers and schools are required to file immunization worksheets.
How to fill out immunization worksheet?
To fill out an immunization worksheet, you need to gather immunization records for individuals and enter the information accurately in the designated sections.
What is the purpose of immunization worksheet?
The purpose of the immunization worksheet is to ensure that individuals have received the necessary vaccinations to protect against certain diseases.
What information must be reported on immunization worksheet?
The immunization worksheet must include information such as individual's name, date of birth, vaccine name, date of administration, and healthcare provider's signature.
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