All-in-one Orientation Package 2024 Xu 1

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Medical Benefit Coverage Waiver Request 免除醫療福利申请

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Waiving Health Coverage 放棄醫療保險(Please select one of the following 請選擇以下一項)(必填)
I understand that it is my sole responsibility to maintain the minimum coverage required by applicable federal regulations. By signing this Medical Benefit Coverage Waiver form, I certify that I and/or my current health insurance plans are legally responsible for my own medical expenses and that Golden Touch Home Health, LLC. is not responsible for such expenses. 本人了解,維持聯邦法規要求的最低醫保是我的個人責任。通過簽署此免除醫療福利申請表,本人聲明 我或/和我當前的醫療保險計劃承擔我個人醫療費用上的法律責任。Golden Touch Home Health LLC 萬有 護理公司不承擔此項費用的責任。
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HEPATITIS B VACCINATION ACCPETANCE/DECLINATION 乙型肝炎疫苗接種

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乙型肝炎疫苗接種(請選擇以下一項)(必填)
I understand that due to my occupational exposure to blood or other potentially infectious materials, I may be at risk of acquiring Hepatitis B (HBV) infection. I have been given the opportunity to be vaccinated with the Hepatitis B at this time. I understand that by declining this vaccine, I continue to be at risk of acquiring Hepatitis B, a serious disease. If, in the future, I want to be vaccinated with the Hepatitis B vaccine, I can receive the vaccination series at no charge to me. 我了解由於我的職業接觸血液或其他潛在的傳染性 根據材料,我可能有感染乙型肝炎 (HBV) 的風險。 此時我有機會接種B型肝炎疫苗。 我了解,如果拒絕接種該疫苗,我將繼續面臨感染B型肝炎的風險,這是一種 嚴重的疾病。 如果將來我想接種B型肝炎疫苗,我可以 我可以免費接受系列疫苗接種。
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