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Administrative Forms

Algorithm for identification of migrant and seasonal farmworkers

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This algorithm in English and Spanish can be used by health center program grantees as part of the intake process to identify farmworker patients.  It incorporates HRSA’s 2012 revised definition of migrant and seasonal farmworkers.

Identifying Migratory and Seasonal Agricultural Workers in Your Clinic

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MCN recommends screening for migrant status at every clinic visit. This bilingual tool is designed to help clinic staff identify migrant and seasonal farmworkers.

Clinic staff should verbally question client at every visit and determine status (migrant farmworker, seasonal farmworker, aged/disabled farmworker, not a farmworker) based on client’s responses.

Sample Service Contract

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THIS AGREEEMENT made effective the date of signing below, between ****** COMMUNITY HEALTH CENTER, INC., hereinafter referred to as “***,” and *****, hereinafter referred to as “****.”........

HRCH Pregnancy Pamphlet- Spanish

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Usted y su bebe pregnancy pamplet.

Incident Report Form

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Two-page form used to report accidents or incidents in the clinic.

Verbal/Telephone Orders and Test Results

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To define a process for accepting verbal or telephone orders and test results directly from physicians, physician extenders (Physician Assistants, Nurse Midwives, Nurse Practitioners), labs and/or testing services.

Education and Professional Development

MCN is committed to providing high quality continuing education to health care providers serving migrant farmworkers. MCN's comprehensive Clinical Education Program helps to develop excellence in practice, clinical leadership, and the dissemination of best models and practices. To best serve individual needs, MCN has devised an array of educational services that can be tailored to clinicians' unique requirements.

HRSA Health Center Program Clinical Requirements

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