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DocuSign Envelope ID: E5125061 -EBDC- 4026- B598- F44E12576444 <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 />(www.cdc.gov/ flu /pi-otect/vaccine /vaceines.litm) 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. Exception: "Family" Refugee Health Assessment <br />(communicable disease and /or physical exam) appointments with 3 or more family <br />members will only be reimbursed 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 />cancelled 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 - 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 06118 <br />