Preplacement (NYN)

New Hire: [text name="newhire" default=""]
DOH:[date name="doh" default=""]
Work Group: NYN
Immunizations: 
MMR: [select name="mmr" value="x2|x3|positive titer received|x2 + positive titer received|titer received today|x1, titer drawn|x1, vaccine given today, VIS provided, consent obtained|none|titer drawn today"]
Varicella: [select name="varicella" value="x2|x3|positive titer received|x2 + positive titer received|titer received today|x1, titer drawn|x1, vaccine given today, VIS provided, consent obtained|none|titer drawn today"]
HepB: not required [text name="hepb" default=""]

TdaP: [select name="TdaP" value="received|given today|"]
FLU:[select name="flu" value="received|given today|"]
COVID: [select name="COVID" value="x3|x2, instructed booster deadline was 3/31/22, needs booster ASAP in order to receive badge"]

TB: [select name="TB" value="drawn @ lab today|received within last 90 days|tested positive in past - has documentation of +tb test, neg chest xray and drs. note stated counseling provided|"]
[text name="tb" default=""]


Allergies: [select name="allergies" value="none|yes"]
[text name="allergies" default=""]
Med Hx: [select name="MedHx" value="none|yes"]
[text name="medhx" default=""]
Accommodations: [select name="Accommodations" value="none|yes"]
[text name="accomodations" default=""]


OHS Clearance: [select name="OHS_clearance" value="pending|cleared"]
Needs:
[text name="needs" default=""]