Event Sign Up Sheet | Track It Forward

TB Clinic Transportation Opportunity!

Thursday, June 15 2023

Client Name(s): Ivan Pavliukh
Number of individuals to transport: 1
Language: Ukrainian
Client Phone Number: (585) 910-5459
DOB: 3.23.1968
Appointment Date: 6.15.23
Pick- up time: 8:30am
Appointment Time: 9am
Pick-up location: 1601 Fetzner Rd, Rochester, NY 14626
Appointment location: 222 Alexander Street, Suite 5000, Rochester, NY 14607
Provider: TB testing
Estimated time volunteering: 2 hours
Client should bring: medicaid cards, medical records
Important Information:
- Please wear your volunteer lanyard
- Please assist the client(s) with checking in and ensure all contact info is correct. Request a phone interpreter if necessary. Don’t hesitate to use the Google Translate App or Tarjimly App.
- If client does not have Medicaid card, let the office know that Medicaid is pending (this should be sufficient).
- If medication needs to be picked up at the pharmacy, please let Elisabeth know at 585.622.4336, and a Case Manager will pick up.
- Please take a photo of the After-Visit Summary with any follow up appointments and email it to the Volunteer Coordinator, Elisabeth at estojkovic@wr.org. Please also include any important information about the appointment that would need to be passed along to the Case Manager.
- Call or text Elisabeth if you have any questions about the location of the appointment or the appointment itself: 585.622.4336
- Please track your hours on Track it Forward

8:30am - 10:30am
Medical Appointment Transportation Opportunity
Client Name(s): Ivan Pavliukh Number of individuals to transport: 1 Language: Ukrainian Client Phone Number: (585) 910-5459 DOB: 3.23.1968 Appointment Date: 6.15.23 Pick- up time: 8:30am Appointment Time: 9am Pick-up location: 1601 Fetzner Rd, Rochester, NY 14626 Appointment location: 222 Alexander Street, Suite 5000, Rochester, NY 14607 Provider: TB testing Estimated time volunteering: 2 hours Client should bring: medicaid cards, medical records Important Information: - Please wear your volunteer lanyard - Please assist the client(s) with checking in and ensure all contact info is correct. Request a phone interpreter if necessary. Don’t hesitate to use the Google Translate App or Tarjimly App. - If client does not have Medicaid card, let the office know that Medicaid is pending (this should be sufficient). - If medication needs to be picked up at the pharmacy, please let Elisabeth know at 585.622.4336, and a Case Manager will pick up. - Please take a photo of the After-Visit Summary with any follow up appointments and email it to the Volunteer Coordinator, Elisabeth at estojkovic@wr.org. Please also include any important information about the appointment that would need to be passed along to the Case Manager. - Call or text Elisabeth if you have any questions about the location of the appointment or the appointment itself: 585.622.4336 - Please track your hours on Track it Forward
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Contact the event organizers: Elisabeth Stojkovic