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VACCINE REGISTRATION FORM DATE___ PATIENT NAME: ___ DATE OF BIRTH___AGE___ ADDRESS: PHONE (STREET___ CITY___ ZIP CODE___) ___IF PATIENT IS UNDER 18: PARENT OR LEGAL GUARDIANS NAME___ RELATIONSHIP
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01
Make sure to obtain the necessary forms from the school or clinic staff.
02
Fill out the forms with accurate and up-to-date information about the student.
03
Provide any required medical information or authorization for treatment.
04
Submit the completed forms to the designated school-based clinic personnel.

Who needs andrews elementary school-based clinic?

01
Students attending Andrews Elementary School who require medical care or treatment during school hours.
02
Parents or guardians of students who want to ensure their child has access to on-campus medical services.
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Andrews elementary school-based clinic is a healthcare facility located within Andrews Elementary School that provides medical services to students, staff, and sometimes the community.
The school administration or healthcare provider operating the clinic is responsible for filing and maintaining records for the Andrews elementary school-based clinic.
The clinic records must be updated regularly with information on the services provided, number of patients served, and any relevant medical data.
The purpose of the clinic is to promote the health and well-being of students and staff by providing convenient access to medical care on site.
The clinic must report data on the number of patients seen, types of services provided, medications administered, and any referrals made to outside healthcare providers.
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