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Get Cox Health Immunization Record Form

Dep t Shadowing: Birthdate/Age We are dedicated to protecting you and our patients from infectious disease. Documentation of the following immunizations is required prior to beginning your shadowing/observation experience. A photocopy of your immunization record may be attached to this form as proof of immunization. Hepatitis B (series of 3 Varicella (2 sh.

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  • INFECTIOUS
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