URGENT INFORMATION --- Please read with a PARENT

Hi All,

The following information needs to be faxed to me.  PLEASE READ:

 *******   URGENT   *******     ******* URGENT *******  ******* URGENT *******
November 2, 2012

Dear Parents,

The healthcare industry is constantly changing and I have been presented with a new challenge, a challenge that can be addressed and met successfully…with your help!!!

Please ask your doctor or pharmacist for the information below on the form that was filled out when the student received the flu shot. It can be brought in by the student or FAXED to this number immediately…. FAX (925) 606-4808 (cover sheet addressed to me)

The local hospitals have given me an urgent request for the following:

Here is what I need on their form. SIGNATURE of person that gave the shot or the doctor's is REQUIRED.

1. STUDENT NAME AND DOB
2. FACILITY WHERE FLU SHOT GIVEN
3. DOSE
4. ROUTE
5. RIGHT OR LEFT DELTOID?
6. DATE VACCINATED
7. LOT NUMBER AND EXPIRATION DATE
8. VIS DATE (VACCINE INFORMATION STATEMENT)
9. MANUFACTURER
10. SIGNATURE OF PERSON WHO GAVE THE INJECTION OR THE DOCTOR’S SIGNATURE

KAISER PATIENTS:  If they do not want to fax this info to me, get me a phone number and contact person that you spoke with.  THANK YOU!

FIELD TRIP FORMS-  Please fill out everything but the dates and times and bring them MONDAY.

Also for MONDAY:  Resume' and cover sheet for your portfolio.  BRING SHEET PROTECTORS!!! 25-30

Skit preparation time will be given and we'll get started with the presentations MONDAY.

ASSIGNMENT and PARENT LETTER - Please go over these with your family before MONDAY.

Thank you PM class today!!!!  You were so much help to me getting the clasroom organized.  GREAT JOB.

Mrs. Erceg

p.s.  Be ready for MONDAY.  :-)                  DON'T FORGET TO SET YOUR CLOCKS "BACK"!