APPLICATION FOR YELLOW FEVER VACCINATION VALIDATION UNIFORM STAMP AND VACCINATION SITE AGREEMENTVaccination Site Agreement • March 3rd, 2021 • Kansas
Site where vaccine will be administered (Note: Uniform Stamp is not transferrable to other sites and only one site should be listed. If you need a stamp for another location please fill out a separate application for each site.)
VACCINATION SITE AGREEMENT (COVID-19) FOR CLOSED POINT OF ADMINISTRATION BETWEEN STATE OF FLORIDA, DEPARTMENT OF HEALTH NASSAU COUNTY HEALTH DEPARTMENT AND (________________ ORGANIZATION)Vaccination Site Agreement • December 28th, 2020
This Vaccination Site Agreement for a Closed Point of Administration (“Agreement”) is made and entered into by the State of Florida, Department of Health, Nassau County Health Department, hereinafter referred to as the “Health Department”, and ___________, hereinafter referred to as the “Organization.” Health Department and Organization are jointly referred to as the “parties.”
