Please use this official RHODE ISLAND DEPARTMENT OF HEALTH online form to report aggregate information on influenza vaccination of healthcare workers engaged in direct patient contact in your facility between September 1, 2008 and April 30, 2009 (influenza vaccination season). This online form faithfully parallels "Form 2" (MS Word format) found on the website of the Rhode Island Department of Health:

http://www.health.ri.gov/hcw/index.php