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Get the free GO 21-17 re Vaccination and Testing Policy (2021.10.1).pdf

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1 2 3 4 October 1, 20215 6 7 8UNITED STATES DISTRICT COURT9CENTRAL DISTRICT OF CALIFORNIA10 11 12 13 14IN RE: CORONAVIRUS PUBLIC EMERGENCY ORDER CONCERNING POLICY REGARDING COVID-19 VACCINATION AND
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To fill out go 21-17 re vaccination, follow these steps:
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Start by providing your personal information such as your name, date of birth, and contact details.
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Next, mention the type and date of the vaccination you received.
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Specify the country and city where you received the vaccination.
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Indicate the vaccine manufacturer and the lot number.
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Mention any side effects or adverse reactions you experienced, if applicable.
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Provide the name and contact information of the healthcare professional who administered the vaccine.
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Finally, sign and date the form to complete the process.

Who needs go 21-17 re vaccination?

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Go 21-17 re vaccination form is required for individuals who have received a vaccination and need to report it or keep a record.
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This form may be needed for various purposes such as travel, employment, or educational institutions.
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It is important to check the specific requirements of the organization or authority requesting the form to ensure compliance.

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