Video Areas

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Video Areas
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Persons arriving in the Video area will have
their paperwork with them.

• If they do not, have a supply of forms on hand in
  the Video Area
• Staff will need to know where packet of forms are
  supplied.

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Video Area will allow for

• persons to view the CDC Video
• persons to complete all necessary paperwork
• persons with certain conditions to be referred to
  the Medical Screening Area
• the entire process to take 20-30 minutes

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CDC Video

• Will be used to provide Smallpox Disease and
  Vaccine Information
• FDA regulations require that persons view the
  video

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Video Areas
Persons will arrive to the Video Areas with an
Information Packet from the Forms Distribution
Area.
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Information Packet contains(DRAFT ONLY)

• Education materials on Smallpox Vaccine
• Medical Screening Form
• Vaccine Documentation Form
• Instructions on How to Care for the Vaccination
  Site

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Video Area Staff

• Will refer non-English speaking persons to the
  Special Assistance Area for an Interpreter.
• If a person is anxious, hostile, or disoriented,
  find Security for assistance.

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Video Staff

• Will need to be familiar with the TV/VCR
  operation and be able to rewind the tape.
• Will direct people into each Video Session Area

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Before starting the video

• Staff will explain to the group the purpose of
  the video which is to provide Smallpox
  Disease/Vaccine Information.
• The video will explain certain conditions that
  may prevent a person from receiving the vaccine

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After viewing the Video

• Staff will instruct the group to complete their
  paperwork and sign the Medical Screening and
  Consent Form.
• Time is allowed for reading and completing the
  paperwork.

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Video Area Staff
Will check each vaccine recipients form for
completeness and accuracy. Hand-out Medical
Screening and Consent Form (Example only)
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If a person has answered

• Yes or Maybe to any of the conditions listed on
  the Medical Screening and Consent Form Refer
  them to the Medical Screening and Consultation
  Area or they may choose to exit the clinic.
• No to any of the conditions listed on the Medical
  Screening Form direct them to the Vaccination
  Area with their forms

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Signs may be posted directing persons to either
the Medical Screening Area or the Vaccination
Area.
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If a person declines to be vaccinated, they may
exit the clinic.