Αποτελέσματα Αναζήτησης
o This vaccine is appropriate for this patient based on the responses to the screening questions and age guidelines according to ACIP recommendations, Giant Eagle’s current vaccine protocols, and state or federal regulations. o Appropriate written education has been provided to the patient, including a Well Child Visit Reminder as applicable.
I have reviewed the Vaccine Screening Questionnaire to assess the patient for potential contraindications and precautions to the vaccines being administered today. I have confirmed vaccine requested is indicated for the patient.
I understand the benefits and risks of the vaccine(s). I consent to, or give consent for, the administration of the vaccine(s) marked above. I authorize the information to be forwarded to my primary care physician, authorizing physician or local Dept. of Health if applicable.
Covid-19 Vaccination Card update/ issue request service is specified for all individual vaccinated by Dubai Health Authority or one of the Emirate of Dubai private vaccination center, who are requesting information update or have an issue with Covid-19 Vaccination Card details.
You can use any of these options (MRN number / Emirates ID or Passport number) to download your vaccination card. DHA facilities and systems use these numbers as unique identification of patient's medical history and the care that he/she received.
Microsoft Word - Patient Authorization - Fillable Form - Unprotected (002) copy.docx. Completed Authorizations may be fulfilled by the pharmacy or may be faxed, emailed, or mailed to: Giant Eagle Privacy Office, Attn: Profiles Coordinator, 101 Kappa Drive, Pittsburgh, PA 15238 412-967-4966 (phone); 412-968-9367 (fax); privacyoffice@gianteagle.com.
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