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Patient Eligibility Screening Record
Vaccines for Children Program
This record must be kept in the healthcare provider\'s office to reflect the current status of all
children 18 years of age or younger
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What is this record must be?
This record must be a financial disclosure form.
Who is required to file this record must be?
This record must be required to be filed by all employees.
How to fill out this record must be?
This record must be filled out electronically using the online form provided.
What is the purpose of this record must be?
The purpose of this record must be to provide transparency and prevent conflicts of interest.
What information must be reported on this record must be?
The information that must be reported includes financial assets, liabilities, and sources of income.
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