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Date 03/23/09 <br />s' ~-c <br />~'..~ 4; <br />c~,m~~y: <br />I'~ ~ i i n Ir~~i,ic ?<'lcdicalGroup <br />C. TY OP SANTA ANA - EXPOSURES/LYNN HWE <br />P.O. IsOX i 988, M-~1 <br />SANTA ANA, CA 92702 <br />Protocol: .EXPOSURE S <br />Page 2 <br />9G713-A 90718-,~ Tetanus & Diptheria AbsorbedlAduit WC 40.00 <br />90716 VXVaricella VARICELLA/Chicken Pox Vaccine 135.00 <br />1'~52G0 O~: ~V;;u~,cCinr WOUND CLEANSER, ANY TYPE 20.00 <br />31 GO1 1. ~~ '' `::' i !- URINALYSIS WITH MICRO 1fl.00 <br />71(?ZO X::.:..~:;:?~,~ XIZ CI•IEST2 VIEWS 60.00 <br />Bill To Name: CITY OF SANTA ANA -EXPOSURES <br />:1r':i~ess: LYNN IIWANG <br />P.O. BOX 1988, M-41 <br />S: `.:~Tf'~ ANA, CA 92702 <br />]'ax:• ;~;} t,:,7_~994 LIIWANGLSANTA-ANA.ORG <br />Crntact: L1`Niti' HWANG <br />BACK OFFICE: FOR B L:. C~ll130RNI:1':'~. " `_)G E'~ EXPOSURES ALWAYS DO BLOODWORIt THIS <br />SHOULD INCLUDE A CI :r '; CHIP, HIiP ,1., ' :, A:~~;) I.11v. it WITHIN THE GOLDENHOUR AND <br />DOCTOR WANTS TO DTSi'i;\SE COMBI~-'I .Z, YC)U MAY GIVE THE EXPOSED EMPLOYEE ONE OR <br />TWO PILLS. TI~IF,Rr~'.• ^~' -"`' ~r ~'•P TIT,'" ~Eli~_'S TO BE CALLED INTO THE PHARMACY. <br />MEI)ICATTO.NS: W liTity C'_LL1NG IN T,i I:1>! t:AT1ON TRY 1'0 USE RTI'E-AID , SAV-ON OR <br />WALGREENS. MAT<lw :'1 '•:OTfi OP THE 1': i:~IZ.vIAGY NUMBER IN TIC PATIENTS FILE AND ON THE <br />FRONT SCREEN OI~ 'I'I1 i "C1?.4PLUTE FC Z FCs'Ct. RE tiSE. ALSO GET THE PI~ARMACY'S FAX <br />NUMBER SOTHAT DEil-l;~G?2t1PHICS AN D B ILLING/CLAIM INFORMATION CAN BE FAXED TO <br />THEM. <br />25A-14 <br />Other: Eax: <br />Speeiai Instructions: <br />FYtONT OFFICE: FAX MSU (14ARKL•'D 1~;•:!'USL`RE) AND OTHEIZPAPERWORKTO LYNNHWANG <br />AT ABOVE NUMBER. '1'11i>>1 E-MAIL Ll'N' : 1I~'~%:~IQG WI"1'H INFORMATION ABOUT THE <br />EXPOSURE. <br />