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CHI St. Joseph Health Occupational Health Influenza Vaccine Assessment & Consent Form 20172018 Information about person to receive vaccine: Last Name:First Name:MI:DOB:Social Security #Age:IF YOU
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Start by obtaining the necessary forms from Joseph Health Occupational Health department.
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Carefully read the instructions on each form and understand the information required.
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Fill out your personal information, including full name, address, contact number, and email.
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Provide details about your occupation, including job title, employer, and work schedule.
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Fill in your medical history accurately, including any past illnesses, surgeries, or conditions.
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Complete the section regarding any current medications you are taking or allergies you have.
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If applicable, provide information about any workers' compensation claims or previous occupational health assessments.
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Submit the filled-out form to the designated contact person at Joseph Health Occupational Health department.

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Joseph Health Occupational Health is a program designed to promote and maintain the health and well-being of employees in the workplace.
All employees and employers are required to participate in the Joseph Health Occupational Health program.
Employees can fill out the Joseph Health Occupational Health forms online or in person at designated health facilities.
The purpose of Joseph Health Occupational Health is to prevent work-related injuries and illnesses, and promote a healthy work environment for employees.
Employees must report any pre-existing medical conditions, work-related injuries, and exposure to hazardous materials on the Joseph Health Occupational Health forms.
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