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STAFF USE Clinic Site: Verified by: CONNECTICUT STATE EMPLOYEE 2016 INFLUENZA IMMUNIZATION CONSENT Patient Name (Full name including middle name/initial as it appears on card):Gender Date of Birth
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What is connecticut state employee?
A Connecticut state employee is an individual employed by the state government of Connecticut.
Who is required to file connecticut state employee?
Connecticut state employees are required to file Connecticut state employee forms.
How to fill out connecticut state employee?
Connecticut state employees can fill out the forms online or by mail.
What is the purpose of connecticut state employee?
The purpose of Connecticut state employee forms is to report income earned by state employees.
What information must be reported on connecticut state employee?
Information such as wages, bonuses, and other compensation must be reported on Connecticut state employee forms.
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