Form 0920-0978 FluSurv Net Provider Vaccination History Fax Form
[NCEZID] Emerging Infections Program
Att14- FluSurv-Net_Provider Vaccination HIstory_Children_Adult
Influenza Hospitalization Surveillance Project Provider Vaccination History Fax Form (Children/Adults)
OMB: 0920-0978
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0920-0978 can be found here:
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| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |