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DocuSign Envelope ID: 37E05944- 6119 - 4717- A9E3- 4C519DD0322C <br />iii. Provide proof of Tdap vaccine. <br />iv. Provide proof of current influenza (flu) vaccine. <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 />(Nv\vw.cdc.govlfltt/protect /vaccine /vaccines.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 />County's Responsibilities. Exception: "Family" Refugee Health Assessment <br />(communicable disease and /or physical exam) appointments with 3 or more family <br />members will only be reinibursed for a total of two (2) hours in the case of same day <br />cancelled appointments. OCHD will not reimburse the Provider if an appointment is <br />cancel led with more than 24 hour notice. <br />Replace Section 4.b.iii 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-rclated <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 />S <br />Revised 06118 <br />