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St. Francis Hospital and Medical Center H1N1 Influenza Vaccination Informed Consent Inactivated, injectable Last Name First Name Middle Initial AGE: (required) Department Job Title Please answer the
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St. Francis Hospital is a medical facility located in New York.
All healthcare providers who operate St. Francis Hospital are required to file the necessary documentation.
You can fill out the forms online or in person at the hospital.
The purpose of St. Francis Hospital is to provide medical care to patients in need.
Information such as patient demographics, medical services provided, and billing information must be reported on St. Francis Hospital forms.
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