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Verification Form Flu Shot Participants covered under the State of Rhode Island medical plan and eligible for the Rewards for Wellness ProgramParticipants receiving their flu vaccine at a State sponsored
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How to fill out verification formflu shot
How to fill out verification formflu shot
01
Obtain the verification form for the flu shot from your healthcare provider or employer
02
Fill out your personal information such as name, date of birth, and contact details
03
Provide details about the flu shot you received including the date, location, and type of vaccine
04
Sign and date the form to certify that the information provided is accurate
05
Submit the completed verification form to the relevant party as required
Who needs verification formflu shot?
01
Individuals who have received a flu shot and need to provide proof of vaccination for school, work, travel, or other purposes
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