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DocuSign Envelope ID:9A043OD9-7ACC-4C25-8C5E-7A2CO072060E <br /> v Unless otherwise provided, proof of immunization must take the form of <br /> one of the following: Provider's immunization record or medical record <br /> signed by a representative of the Provider's healthcare practice In either <br /> case both the Provider's name and the date of immunization must be present <br /> Only vaccines approved by the Centers for Disease Control and Prevention <br /> (www cdc gov/flu/protect/vaccine/vaceines htm) will be accepted the <br /> provider is responsible for the costs associated with acquiring the <br /> vaccination <br /> Replace Section 3 with the following paragraph: <br /> 3. County's Responsibilities County will compensate Provider as provided in subsection 4 <br /> for interpretation and translation services at the rate prescribed Per hour reimbursement <br /> will begin at the time the Provider meets with County staff for the appointment and ends <br /> at the time the staff and interpreter contact is completed Ihere will be a minimum of <br /> one (2) hour of service for an appointment. OCHD will reimburse the Provider for one <br /> (2)hour of interpretation service in the event of a same day cancelled appointment. Ihat <br /> includes appointments for clients who do not show up for an appointment, and for those <br /> who cancel an appointment with less than 24 hour notice Exception: "Family"Refugee <br /> Health Assessment (communicable disease and/or physical exam) appointments with 3 <br /> or more family members will only be reimbursed for a total of two (2) hours in the case <br /> of same day cancelled appointments. OCHD will not reimburse the Provider if an <br /> appointment is cancelled with more than 24 hour notice <br /> Replace Section 4 b iii with the following paragraph: <br /> iii. In the event of a cancelled appointment, the Provider is required to stay until <br /> relieved of duty by the nurse supervisor or the individual in charge of <br /> clinical operations OCHD staff may require other interpreter-related <br /> services in place of the scheduled appointment. As stated above, the <br /> Provider may submit an invoice in the event of a broken appointment (with <br /> less than 24 hour notice). <br /> Revised 06115 7 <br />