Orientation Form RN ChenFull Name 姓名(必填) First Name 名 Last Name 姓 Aide Code 護理員號碼(必填)Address 地址 Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Initial 縮寫(必填)Signature 簽名(必填)HiddenAdministrative StuffHiddenRN Evaluator 名 姓 HiddenRN InitialHiddenLIC. NumberHiddenAide PositionHiddenHEP B Vaccination Yes, I accept vaccination No, I decline vaccinationPhoneThis field is for validation purposes and should be left unchanged.
