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20162017 FLU VACCINE SCREENING AND CONSENT Patient Name: Allergies List: Known Latex Allergy? () Yes () No Known Egg Allergy? () Yes () No Tell us a bit about the egg allergy () Difficulty Breathing
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Gather the necessary documents such as your identification, health insurance information, and any relevant medical records.
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Download the 2016-2017 tp flu screening form from a trusted healthcare website or obtain a physical copy from your healthcare provider.
03
Read the instructions provided on the form carefully to ensure you understand all the sections and requirements.
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Fill in your personal information accurately, including your full name, date of birth, address, and contact information.
05
Provide your health insurance details if applicable, including policy number and any specific requirements for coverage.
06
Answer the screening questions thoroughly and truthfully, providing information about your medical history, symptoms, and any recent flu exposure.
07
Follow any additional instructions regarding supporting documents or certifications that may be required.
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Review the completed form for any errors or missing information before submitting.
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Submit the filled-out form to the designated healthcare provider or follow the submission instructions provided.
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Keep a copy of the filled-out form for your records.
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Wait for a response from the healthcare provider regarding the results or any further steps to be taken.

Who needs 2016-2017 tp flu screening?

01
Individuals who are experiencing flu-like symptoms such as fever, cough, sore throat, body aches, fatigue, or nasal congestion.
02
People who have been in close contact with individuals diagnosed with the flu and are at higher risk of contracting the virus.
03
Some workplaces or schools may require their employees or students to undergo flu screening for prevention and control.
04
Certain individuals with underlying health conditions or weakened immune systems may be advised to get a flu screening.
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TP flu screening is a test that checks for influenza virus infection.
Healthcare providers and facilities are required to file tp flu screening.
TP flu screening can be filled out by collecting respiratory samples from individuals and sending them to a laboratory for testing.
The purpose of tp flu screening is to identify individuals infected with the influenza virus.
Information such as patient demographics, date of collection, type of sample collected, and test results must be reported on tp flu screening.
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2016 Guillan lightheadedness Barre VIS Req DOB recurrent Influenza Vaccination infections Seasonal Revised Latex provider administered medications Allergy consulted VACCINE

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