This is great and thank you for sharing Dr. Fanucchi.

What is the response if an employee answers yes to any of those questions?

Regards,

Mari C

Mari Numanlia-Wone, RN, MSN, MBA

Manager Employee Wellness & Health Services

El Camino Health

2500 Grant Road

Mountain View, CA 94040

Tel: 650-988-7645

Cell: 858-267-8550

From: MCOH-EH <mcoh-eh-bounces@mylist.net> On Behalf Of Dr Joe Fanucchi
Sent: Saturday, December 12, 2020 12:39 PM
To: Swift, Melanie D., M.D., M.P.H. via MCOH-EH <mcoh-eh@mylist.net>
Subject: Re: [MCOH-EH] Informed Consent

WARNING: This email originated outside of the El Camino Hospital email system!
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On 12/12/2020 7:12 AM, Swift, Melanie D., M.D., M.P.H. via MCOH-EH wrote:

Same here. Usual process for vaccination with no special consent form required.

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Good afternoon Melanie,

Just FYI ... several of our MediTrax customers requested that we make a questionnaire/consent form available. This is what we provide (and each facility has the option to modify the questions).

Joe Fanucchi

--

Joe Fanucchi MD FACOEM
President and Medical Director
MediTrax / OHS, Inc.
o:925-820-7758
c:925-368-3367
drjoe@meditrax.com

MediTrax: Everything you need, at a fraction of the cost!