California Intake form for COVID-19 Coronavirus Testing

State:
Multi-State
Control #:
US-CVD-007
Format:
PDF
Instant download

Description

This intake form collects patient information when a COVID-19 coronavirus test is requested.

How to fill out California Intake Form For COVID-19 Coronavirus Testing?

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UPDATE March 7, 2022: The County of Santa Clara Health Officer issued an updated and amended health order requiring up-to-date COVID-19 vaccination for workers ... It is recommended that all COVID-19 test recipients fill out, sign, and bring the initial intake and consent forms linked below, with them to the testing ...Report Cases to Public Health with the SPOT Intake Form (English) (Spanish)If you are interested in offering the COVID-19 Vaccine to your employees, ... Regardless of your vaccination status, have you experienced any of the symptoms in the list below in the past 48 hours? IMPORTANT: ANSWER ?YES? EVEN IF YOU ... Choose a location and time for your COVID-19 test. · Enter the patient information and complete a quick questionnaire. · At the time of your appointment, go to ... Please fill in this form to self-report your at-home test result.testing by visiting California's COVID-19 Testing Task Force's Get Started page. COVID cases in the workplace: How to report an outbreak. If your business has an outbreak: Report an outbreak to Public Health by using the SPOT Intake Form ... COVID-19 Response Recommendations for School Administration DiseaseResources for schools interested in testing include: California's Testing Task Force ... Fill out the short form and upload proof of vaccination in one of two ways: Upload an image or a screenshot of your California Digital COVID-19 Vaccine ... That person will help you get a COVID-19 shot. Please be patient, information is shared with towns once a week on Mondays. You do not have to fill out this ...

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California Intake form for COVID-19 Coronavirus Testing