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How to fill out the Wordshithch Form online
Filling out the Wordshithch Form accurately is essential for adherence to the requirements set by the Employee Health Service. This guide will provide you with step-by-step instructions for completing the form online, ensuring you have all necessary information ready.
Follow the steps to complete the Wordshithch Form effectively.
- Click the ‘Get Form’ button to obtain the form and open it in your online editor.
- In the 'Name' section, print your name clearly (Last, First). Ensure the spelling is accurate to avoid any discrepancies.
- Enter your date of birth in the given field. This is crucial for identification purposes.
- Fill in the section regarding immunity by completing the Measles, Mumps, Rubella, and Varicella antibody titer fields. For each entry, indicate whether you are immune or not immune and provide the date of the titer.
- Document the date of any booster shots if you are not immune in the respective fields.
- Record your childhood immunizations dates in the provided sections, though these will not replace required antibody titer tests.
- Complete the tuberculosis screening section. Indicate if you have completed two negative Tuberculin Skin tests (PPD) or a negative Quantiferon TB Gold test. Provide dates and results for each test.
- If you had a positive PPD in the past, attach a chest x-ray report completed within the last year, also documenting the date and results.
- In the section for documentation completion, enter the name, telephone number, and signature of your health care provider to validate the information.
- Finally, save your changes and ensure you download or print the completed form to bring to your appointment with Employee Health, along with copies of your lab results.
Complete your Wordshithch Form online today to ensure a smooth appointment process.
To make a Word template editable, open your template in Word and click on the 'Restrict Editing' option. You can select areas where users can input information while keeping other sections protected. This ensures your 'Wordshithch Form' maintains its essential structure while allowing necessary edits.
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