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)Click to SignHiddenAdministrative StuffHiddenRN Evaluator 名 姓 HiddenRN InitialHiddenLIC. NumberHiddenAide PositionHiddenHEP B Vaccination Yes, I accept vaccination No, I decline vaccinationNameThis field is for validation purposes and should be left unchanged.
