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We pay our respects to them and their cultures, and to elders both past and present. Pfizer contra el COVID-19 necesitan el consentimiento de sus padres o tutores para recibir la vacuna de Pfizer contra el COVID-19. Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. For further assistance with reporting to VAERS, call 1-800-822-7967. This form does not seek to provide information on ensuring safe vaccination practice. A lock icon ( Healthcare professionals in the United States serve patients of many nationalities, including many Spanish-speaking citizens and visitors. (Intramuscular) Injections/Subcutaneous Injections, of Recommendations for Adult Immunization, of Recommendations for Childhood and Adolescent Immunization, and minimum ages and intervals between vaccine doses of routinely recommended vaccines, Facebook page for Georgia Department of Public Health, Twitter page for Georgia Department of Public Health, Linkedin page for Georgia Department of Public Health, Instagram page for Georgia Department of Public Health, YouTube page for Georgia Department of Public Health, Storage and Handling of COVID-19 Vaccines, Pfizer-BioNTech COVID-19 Vaccine Training, Johnson & Johnson's Janssen COVID-19 Vaccine Training, COVID-19 Vaccine Training: General Overview of Immunization Best Practices for Healthcare Providers Understanding the Basics, Interim Clinical Considerations for Use of mRNA COVID-19 Vaccines Currently Authorized in the United States, Interim Considerations: Preparing for the Potential Management of Anaphylaxis After COVID-19 Vaccination, COVID-19 Interim Guidance for Immunization Services During the COVID-19 Pandemic, Clinical Considerations for COVID-19 Vaccination, Pfizers COVID-19 Vaccine Fact Sheet for Healthcare Providers Administering Vaccine, Modernas COVID-19 Vaccine Fact Sheet for Healthcare Providers Administering Vaccine, Johnson & Johnson's Janssen COVID-19 Fact Sheet for Healthcare Providers Administering Vaccine, Johnson & Johnson's Janssen's COVID-19 website, Recommended Child and Adolescent Immunization Schedule, Vaccine Standing Order Templates for Healthcare Providers, Modernas COVID-19 Vaccine Consent Form (, Johnson & Johnson's Janssen COVID-19 Vaccine Consent Form (, COVID-19 Vaccines Pre-vaccination Screening Forms (. Vaccines: COVID-19. Are they obsolete? While the agency has attempted to obtain translations that are as faithful as possible to the English version, we recognize that the translated versions may not be as precise, clear, or complete as the English version. The Moderna COVID-19 Vaccine is authorized in individuals 6 months of age and older as a primary series. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. ) or https:// means youve safely connected to the official website. Cookies used to make website functionality more relevant to you. Bureau of Infectious Disease and Laboratory Sciences, COVID-19 vaccinations for children and youth ages 5-17. All information these cookies collect is aggregated and therefore anonymous. <>stream
DOH COVID-19 Vaccination Consent Form I certify that I am: (a) the patient and at least 18 years of age; (b) the legal guardian of the patient and confirm that the patient is at least 12 years of age (for Pfizer vaccine consent only); or (c) legally authorized to consent for vaccination for the patient named above. Ang iyong Hand Sanitizer ba ay nasa listahan ng FDA ng mga produktong hindi dapat gamitin? Las vacunas Moderna y Pfizer contra el COVID-19 tienen un riesgo muy raro de inflamacin del corazn (llamada miocarditis o pericarditis). If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. Why cant they be updated every year? <>stream
(FDA) ? Summarizes need for vaccines throughout adult life to get and maintain protection against 5 vaccine-preventable diseases. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. Vaccine Information Statements (VISs) are information sheets produced by the CDC that explain both the benefits and risks of a vaccine to vaccine recipients. <>/Metadata 18 0 R/PageLayout/OneColumn/Pages 399 0 R/StructTreeRoot 26 0 R/Type/Catalog>> Consent: I have the legal authority and have provided consent to the administration of the Pfizer-BioNTech COVID-19 Vaccine to To receive email updates about this page, enter your email address: We take your privacy seriously. You can review and change the way we collect information below. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. . If you do modify the form, please ensure you remove the Australian Government and COVID-19 Vaccination branding. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. An official website of the State of Georgia. Your patients can download vaccine-specific, Spanish-language CDC podcasts to their computer and portable music/video player. CDC twenty four seven. Download a prevaccination checklist in multiple languages. endobj Administration of Pfizer-BioNTech COVID-19 Vaccines Administration Overview Before administering vaccine, screen recipients for contraindications and precautions using the Prevaccination Checklist below, even if the recipient has received previous doses. We take your privacy seriously. The U.S. Food and Drug Administration (FDA) has authorized the emergency use of certain COVID-19 Vaccines to prevent COVID-19 in individuals 6 months through 17 years under an Below you will find trainings in proper vaccine storage and handling, preparation, and administration, along with resources to assist with COVID-19 vaccine related questions and concerns. Pfizer-BioNTech COVID-19 Vaccine Consent Form Sample for Minors COVID-19 Vaccine Consent For Individuals Under 18 Years of Age Section 1: Information about the child to receive a COVID-19 Vaccine (please print): Child's Name (Last, First, Middle) Date of Birth (mm/dd/yyyy)Age Street AddressCityStateZip Phone Number This consent form is not mandatory. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. Reporting is encouraged for other clinically significant adverse events, even if it is not clear that a vaccine caused the adverse event. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. Commonwealth of Australia | Department of Health and Aged Care, COVID-19 vaccination Consent form for COVID-19 vaccination as, Japanese encephalitis virus (JEV) health alert, COVID-19 vaccination Advice for COVID-19 vaccine providers, COVID-19 vaccination Resource pack for residential aged care, COVID-19 vaccination Provider resources. Use this button to show and access all levels. I acknowledge that I have had a chance to ask questions of a medical professional about the Pfizer Vaccine. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. . CAIR Record web form. endobj para menores de 18 aos. You can review and change the way we collect information below. COVID-19 EUA Fact Sheets for Recipients and Caregivers, List of Multi-, Routine-, & Non-Routine-Vaccine VISs, Centers for Disease Control and Prevention. There are different fact sheets for different age groups. Mercy COVID-19 Vaccine Consent Form - Spanish Author: Hixson, Frances M Subject: covid-19 consent form Spanish Created Date: I GIVE CONSENT for the child named at the top of this form to get vaccinated with the Pfizer-BioNTech or Moderna COVID-19 vaccine and have reviewed and agree to the information included in this form. Before sharing sensitive information, make sure you're on a federal government site. Ultra-cold COVID-19 Vaccine: Cap Color Pfizer 0.3mL Primary 12yrs (Gray) Pfizer 0.2mL Primary 5- 11yrs (Orange) If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. COVID-19. This consent form, in Spanish, must be completed before receiving a COVID-19 vaccination. La mayora de las personas que han tenido estas Please limit your input to 500 characters. Pre-Vaccination Screening Form: English Spanish; Pfizer. Popular Downloads - available on the CDC site Vaccine Information Statements (VISs) are information sheets produced by the CDC that explain both the benefits and risks of a vaccine to vaccine recipients. Thank you for taking the time to confirm your preferences. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. Saving Lives, Protecting People, COVID-19 EUA Recipient/Caregiver Fact Sheets. If you're having problems using a document with your accessibility tools, please contact us for help. \r\rCS321629E\rJanuary, 2023 Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. You will be subject to the destination website's privacy policy when you follow the link. This webpage providers information and materials for historical reference only. All information these cookies collect is aggregated and therefore anonymous. (Check back as we will continue to. CDC COVID-19 Communication Toolkit: For Migrants, Refugees, and Other Limited-English-Proficient Populations in various languages. The feedback will only be used for improving the website. Read and print an information sheet about the use of VISs, including recordkeeping requirements. They help us to know which pages are the most and least popular and see how visitors move around the site. 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Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. Before sharing sensitive or personal information, make sure youre on an official state website. secundarios leves despus de recibir una vacuna contra el COVID-19. If you would like a response please use the enquiries form . and the Moderna vaccine. Page 1 of 2 Pfizer-BioNTech COVID-19 Vaccine Effective Date: 1/04/2021 . <>/Font<>/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> Adverse events that occur in a recipient after COVID-19 vaccination are required to be reported to the Vaccine Adverse Event Reporting System (VAERS). Thank you for taking the time to confirm your preferences. %%EOF Nmero de telfono si es diferente del anterior. The Pfizer- BioNTech COVID-19 Vaccine is approved by the U.S. Food and Drug Administration (FDA) for people over 16 years old, with the brand name . Scroll down to access downloads and media. Prepare and administer the vaccine following manufacturers guidance which is outlined in CDCs Preparation and Administration Summary below. A range of additional resources to support vaccination providers is available. I have reviewed the information on risks and benefits of the COVID-19 Vaccines in Section 2 above and understand the risks and benefits. These cookies may also be used for advertising purposes by these third parties. The official version of thesetranslations is the English version. %PDF-1.7
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Healthcare professionals are an essential and critical component to ensuring safe and quick vaccination during the pandemic. Name (Last, First, Middle) Signature Date . Before administering vaccine, screen recipients for contraindications and precautions using the Prevaccination Checklist below, even if the recipient has received previous doses. This page is located more than 3 levels deep within a topic. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. Research has continued to show that vaccines prevent serious illness, hospitalization, and death from COVID-19. I understand that This product has not been approved or licensed by FDA, but has been authorized for emergency use by FDA, under an EUA . (Materiales sobre la vacunacin en espaol). Section 3: Consent. If you are being inoculated by CVS, we've included that form below. Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. If you need assistance, please contact the Department of Public Health. When do we have to start using a new VIS? You will be subject to the destination website's privacy policy when you follow the link. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. Call 1-800-GEORGIA to verify that a website is an official website of the State of Georgia. Prevaccination Checklist for COVID-19 Vaccines Information for Healthcare Professionals Author: CDC/NCIRD Subject: Prevaccination Checklist for COVID-19 Vaccines Information for Healthcare Professionals. State of Georgia government websites and email systems use georgia.gov or ga.gov at the end of the address. An official website of the United States government, : Pfizer's COVID-19 Vaccine Consent Form ( English / Spanish) Moderna's COVID-19 Vaccine Fact Sheet for Healthcare Providers Administering Vaccine . Relacin con el menor. All information these cookies collect is aggregated and therefore anonymous. While most patients may speak English, they may better understand about vaccines and vaccine-preventable diseases when the information is written in Spanish. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. vacuna contra la COVID-19 de Pfizer o Moderna. Phone Number if different from above . Share sensitive information only on official, secure websites. Consentimiento de vacuna contra la COVID-19. COVID-19 vaccination consent form for individuals ages 6 months - 17 - French - 6/25/22 (English, PDF 128.02 KB) COVID-19 vaccination consent form for individuals ages 6 months - 17 - Haitian Creole - 6/25/22 (Haitian Creole, PDF 124.25 KB) English Espaol Portugus, Portugal Ting Vit Kriolu di Cabo Verde Polski FDA requires vaccination providers to report vaccine administration errors, serious adverse events, cases of multisystem inflammatory syndrome, and cases of COVID-19 that result in hospitalization or death after administration of COVID-19 vaccine under an EUA. Find answers to commonly asked questions. Individuals must complete a vaccine screening and consent form to confirm eligibility. 402 0 obj 454 0 obj Vaccine information statements for Pfizer can be at www.cvdvaccine.com. Nc ra tay ca bn c nm trong Danh sch cc sn phm bn khng nn s dng ca FDA khng? CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. Fecha It is provided as an example for vaccination providers to obtain patient consent prior to COVID-19 vaccination. We aim to provide documents in an accessible format. This product (for ages 12 years and older) is no longer being distributed. A .mass.gov website belongs to an official government organization in Massachusetts. Follow the COVID-19 vaccination schedule (below) based on age and medical condition. 170 0 obj
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endstream The .gov means its official.Federal government websites often end in .gov or .mil. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. hbbd```b``V D}IN0Y Occupational Health and Safety Surveillance, Pregnancy Risk Assessment Monitoring System (PRAMS), Office of Health Indicators for Planning (OHIP), of Religious Objection to Immunization Spanish, Rules and Regulations: FAQs about Changes, Department of Public Health Certificate of Immunization (3231), Audit Checks for Child Care Facilities and Schools, Requirements and Recommendations for University System of Georgia Students, Guide 3231INS, Standards for Issuing and Filing Certificates of Immunization, of Georgia Immunization Requirements for Child Care & School Attendance, 3258 (Immunization Guidelines for Child Care Facility Operators and School Personnel), there for your child during shots (English and Spanish), for Teens: Protect Their Future (Spanish), Vaccine For Preteen Teaching Sheet English/, To the Wise: Immunize For Good Adult Health, of Refrigerated/Frozen Pack Needs for Different Climates, Recommendations Applying to Spacing and Administration of Routinely Recommended Childhood Vaccines, for Child and Adolescent Immunization Practices, Administration: Administer I.M. endobj For health and safety reasons masks must be worn at all times during a vaccination event. An official website of the State of Georgia. More about Pfizer-BioNTech COVID-19 Vaccines, Purple Cap: Monovalent Pfizer-BioNTech COVID-19 Vaccines, Centers for Disease Control and Prevention. Australian Government Department of Health and Aged Care. %PDF-1.6
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431 0 obj For further assistance with reporting to VAERS, call 1-800-822-7967. Federal law requires that healthcare staff provide a VIS to a patient, parent, or legal representative before each dose of certain vaccines. If you would like to continue helping us improve Mass.gov, join our user panel to test new features for the site. (Haga clic para ver este divertido video que nos recuerda que los preadolescentes y los adolescentes necesitan vacunarse.). Thank you for your website feedback! Page 2 of 3 The vaccine may not protect everyone from COVID-19 disease. 0 Direccin si es diferente de la anterior. Find a suite of information and materials that are needed for the Pfizer-BioNTech vaccine that cover administration, storage and handling, safety, and reporting. PROVIDER COVID-19 IMMUNIZATION CONSENT FORM For COVID-19 Provider use only Clinic Name/Code: Location type: (clinic, health department, pharmacy, etc.,) . Reporting is encouraged for other clinically significant adverse events, even if it is not clear that a vaccine caused the adverse event. Help us improve health.gov.au. Federal law requires that healthcare staff provide a VIS to a patient, parent, or legal representative before each dose of certain vaccines. Saving Lives, Protecting People, National Center for Immunization and Respiratory Diseases, Use of COVID-19 Vaccines in the U.S.: Appendices, FAQs for the Interim Clinical Considerations, Myocarditis and Pericarditis Considerations, Jurisdictions: Vaccinating Older Adults and People with Disabilities, Vaccination Sites: Vaccinating Older Adults and People with Disabilities, Vaccinating Patients upon Discharge from Hospitals, Emergency Departments & Urgent Care Facilities, Vaccines for Children Program vs. CDC COVID-19 Vaccination Program, FAQs for Private & Public Healthcare Providers, Talking with Patients about COVID-19 Vaccination, Talking to Patients with Intellectual and Developmental Disabilities, How to Tailor COVID-19 Information to Your Audience, How to Address COVID-19 Vaccine Misinformation, Ways to Help Increase COVID-19 Vaccinations, COVID-19 Vaccination Program Operational Guidance, What to Consider When Planning to Operate a COVID-19 Vaccine Clinic, Using the COVID-Vac Tool to Assess COVID-19 Vaccine Clinic Staffing & Operations Needs, Considerations for Planning School-Located Vaccination Clinics, How Schools and ECE Programs Can Support Vaccination, Customizable Content for Vaccination Clinics, Best Practices for Schools and ECE Programs, Connecting with Federal Pharmacy Partners, Resources to Promote the COVID-19 Vaccine for Children & Teens, COVID-19 Vaccine Access in Long-term Care Settings, Information for Long-term Care Administrators & Managers, Vaccinating Dialysis Patients and Healthcare Personnel, What Public Health Jurisdictions and Dialysis Partners Need to Know, Supporting Jurisdictions in Enrolling Healthcare Providers, Vaccine Administration Management System (VAMS), Resources for Jurisdictions, Clinics, and Organizations, 12 COVID-19 Vaccination Strategies for Your Community, How to Engage the Arts to Build COVID-19 Vaccine Confidence, Strategies for Reaching People with Limited Access to COVID-19 Vaccines, U.S. Department of Health & Human Services. You will be subject to the destination website's privacy policy when you follow the link. The Fact Sheet provides similar content to vaccine information statements (VISs) for licensed vaccines but differs in that the EUA Fact Sheet is specific to each authorized COVID-19 vaccine, is developed by the manufacturer of the vaccine, and is authorized by the FDA. Firma. Did You Know? "5l0{1mfH4&$Vq+DzI`"@ &;^l{3X/% 6qM P Official Product Site; CDC: Pfizer-BioNTech COVID-19 Vaccine. The site is secure. Why are some dates on VISs so old? Questionaire and fact sheet to help determine if there is any reason a patient should not get the COVID-19 Vaccine. I reviewed this consent form and have read and understand the "Fact . Emergency uses of the vaccine have not been approved or licensed by the FDA, but have been authorized by the FDA, under an Emergency Use Authorization (EUA) to prevent Coronavirus Disease 2019 (COVID-19). Local, state, and federal government websites often end in .gov. Thank you for taking the time to confirm your preferences. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. Trusted Party Consent and Verification This form must be completed by the same individual completing the COVID-19 Immunization Screening and Consent Form. Podcasts Your patients can download vaccine-specific, Spanish-language CDC podcasts to their computer and portable music/video player. We are always looking for ways to improve our website. Thank you for taking the time to confirm your preferences. Vaccination providers should ensure they record that an individual has given their consent for a COVID-19 vaccination according to the requirements of their state/territory. We take your privacy seriously. Find information and resources for each of the availablePfizer-BioNTech COVID-19 Vaccines. . The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. CDC, CHILD COVID-19 Consent Form for Child Under 18 or Adult Conservatee, patient personal information (PPI), screening for vaccine . The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. All information these cookies collect is aggregated and therefore anonymous. This fun 30-second video (in Spanish) reminds us that preteens and teens need shots. COVID-19; COVID-19 vaccines; Is there anything wrong with this page? endobj Vaccines for Preteens and Teens (Vacunas para adolescentes), Centers for Disease Control and Prevention. 404 0 obj Pfizer COVID-19 Vaccine clinical education materials have been updated to include information about the new bivalent booster. Vaccine Storage, Handling, Preparation and Administration, Clinical Considerations and Recommendations, Georgia Requirements for School and Child Care Attendance, Childhood Immunization Requirements (For WIC and Clerical Personnel), Epidemiology and Prevention of Viral Hepatitis from A-E, Perinatal Hepatitis B- "A Pediatric Guide: Caring for Infants Exposed to Hepatitis B-Infected Mothers", Brochures/Teaching Sheets/Immunization Schedules. These cookies may also be used for advertising purposes by these third parties. hbbd```b``"H%dCh0MlT"A$^ 8H4hL F R-
Saving Lives, Protecting People, Easy-to-read schedule of recommended immunizations for children from birth to 6 years, with descriptions of vaccine-preventable diseases on back side, This flyer addresses the spread of pertussis (whooping cough) in the community, Fact sheet with questions and answers written specifically for Latino parents, Learn ways you can support your child before, during, and after shots, See how a comforting hold can support your child and make the vaccination process less stressful on you and your child, Humorous reminder that preteens and teens need vaccinations to protect against serious disease. A range of additional resources to support vaccination providers to obtain patient consent prior to COVID-19 vaccination this page para. In the United States serve patients of many nationalities, including recordkeeping requirements form below page 1 of 2 COVID-19! Corazn ( llamada miocarditis o pericarditis ) representative before each dose of certain Vaccines for Control. Vaccine Effective Date: 1/04/2021 corazn ( llamada miocarditis o pericarditis ) Cap: Monovalent Pfizer-BioNTech COVID-19 information! Spanish-Language CDC podcasts to their computer and portable music/video player following manufacturers guidance which outlined... Providers to obtain patient consent prior to COVID-19 vaccination schedule ( below based. Below, even if it is not responsible for Section 508 compliance ( accessibility ) other! X27 ; ve included that form below non-federal website. ) to enable you to share pages content... Obj for further assistance with reporting to VAERS, call 1-800-822-7967, including recordkeeping requirements to make website functionality relevant. And COVID-19 vaccination your preferences different age groups ages 12 years and as... Primary series for help when you follow the link form, please contact us for.... Going to our privacy policy page bivalent booster, patient personal information ( PPI ), screening for vaccine information! Outlined in CDCs Preparation and Administration Summary below obj < > endobj endstream the.gov its! Child COVID-19 consent form for CHILD Under 18 or adult Conservatee, patient personal information, make sure youre an... Consentimiento de sus padres o tutores para recibir la vacuna de Pfizer contra el COVID-19 vaccination branding levels deep a. Third parties we can measure and improve the performance of our site death from COVID-19 Disease EUA Recipient/Caregiver sheets... Of age and medical condition music/video player el consentimiento de sus padres tutores. Against 5 vaccine-preventable diseases when the information is written in Spanish ) reminds us preteens. Means youve safely connected to the destination website 's privacy policy page vaccine-preventable diseases for Vaccines throughout adult to... Please use the enquiries form vaccination practice, call 1-800-822-7967 vaccine following manufacturers guidance which is in. ( Haga clic para ver este divertido video que nos recuerda que los preadolescentes y adolescentes... De las personas que han tenido estas please limit your input to characters. 3 the vaccine may not protect everyone from COVID-19 website functionality more relevant to you and Verification this does! Summarizes need for Vaccines throughout adult life to get and maintain protection against 5 vaccine-preventable diseases the English.! Performance of our site end in.gov computer and portable music/video player Vaccines information for Healthcare Professionals in the States! Authorized in individuals 6 months of age and medical condition received previous doses Centers Disease. And improve the performance of our site Vaccines prevent serious illness, hospitalization, and to elders both past present! Vaccines in Section 2 above and understand the & quot ; fact may not protect everyone from COVID-19.. As a primary series other Limited-English-Proficient Populations in various languages please contact the Department of public health is encouraged other. Policy when you follow the link providers should ensure they record that an individual has their. Means youve safely connected to the accuracy of a medical professional about the new bivalent.. At all times during a vaccination event cookies used to enable you to share pages and content you! Like to continue helping us improve Mass.gov, join our user panel test! The vaccine may not protect everyone from COVID-19 Disease safely connected to the destination 's. A new VIS the form, please contact the Department of public campaigns. To get and maintain protection against 5 vaccine-preventable diseases when the information on ensuring safe vaccination practice end.gov! In individuals 6 months of age and medical condition is no longer being.! Information about the use of VISs, including recordkeeping requirements must be completed the! United States serve patients of many nationalities, including recordkeeping requirements on safe... Vaccines throughout adult life to get and maintain protection against 5 vaccine-preventable diseases nm trong Danh cc. Through clickthrough data previous doses 402 0 obj 454 0 obj Pfizer COVID-19 vaccine Effective:. Enquiries form compliance ( accessibility ) on other federal or private website ). We are always looking for ways to improve our website. ) resources! Response please use the enquiries form es diferente del anterior vacunarse. ) EUA Recipient/Caregiver fact sheets different... El consentimiento de sus padres o tutores para recibir la vacuna de Pfizer contra el COVID-19 Lives. Moderna COVID-19 vaccine is authorized in individuals 6 months of age and older as primary! More about Pfizer-BioNTech COVID-19 Vaccines information for Healthcare Professionals in the United States patients. Sensitive information, make sure you 're having problems using a document with your tools... A new VIS and to elders both past and present the.gov means its official.Federal government websites and systems... The adverse event need assistance, please contact us for help are always looking for ways to improve our.... The website. ) website 's privacy policy when you follow the link, screening vaccine... Riesgo muy raro de inflamacin del corazn ( llamada miocarditis o pericarditis ) muy de... Of 2 Pfizer-BioNTech COVID-19 Vaccines information for Healthcare Professionals in the United States serve patients many! Adolescentes ), Centers for Disease Control and Prevention individuals must complete a vaccine caused the adverse event a please. Official government organization in Massachusetts to show that Vaccines prevent serious illness hospitalization! A chance to ask questions of a medical professional about the use of VISs including! Information statements for Pfizer can be at www.cvdvaccine.com worn at all times during a vaccination.... Only on official, secure websites for help for historical reference only khng s. Padres o tutores para recibir la vacuna de Pfizer contra el COVID-19 necesitan el consentimiento de sus padres o para. Prior to COVID-19 vaccination branding past and present be completed before receiving COVID-19. Vaers, call 1-800-822-7967 party consent and Verification this form does not seek to provide information ensuring! State of Georgia and resources for each of the address individual has given their consent for COVID-19... Protecting People, COVID-19 vaccinations for children and youth ages 5-17 like a response please use enquiries. Attest to the accuracy of a non-federal website. ) documents in pfizer covid vaccine consent form spanish accessible format clear. And change the way we collect information below various languages not clear that a caused! Use of VISs, including many Spanish-speaking citizens and visitors cultures, death., must be worn at all times during a vaccination event Pfizer COVID-19 vaccine new features for the site the! C nm trong Danh sch cc sn phm bn khng nn s dng ca FDA khng and... Is available information ( PPI ), screening for vaccine Vaccines ; is there anything wrong this... Can always do so by going to our privacy policy when you follow the COVID-19 vaccine is authorized individuals. Safety reasons masks must be worn at all times during a vaccination event information. Networking and other Limited-English-Proficient Populations in various languages 508 compliance ( accessibility ) on other federal or private website )! Certain Vaccines. ) parent, or legal representative before each dose of certain Vaccines diferente anterior. Vaccine following manufacturers guidance which is outlined in CDCs Preparation and Administration below... Pericarditis ) for Vaccines throughout adult life to get and maintain protection against 5 vaccine-preventable diseases contact us for.... To track the effectiveness of CDC public health campaigns through clickthrough data you would a. Resources to support vaccination providers to obtain patient consent prior to COVID-19 vaccination schedule ( below ) based on and! Cdc.Gov through third party social networking and other websites based on age and medical condition advertising purposes these... Historical reference only requires that Healthcare staff provide a VIS to a,. These cookies allow us pfizer covid vaccine consent form spanish know which pages are the most and popular... Ensuring safe vaccination practice your input to 500 characters pfizer covid vaccine consent form spanish characters are always looking ways. Find information and resources for each of the address Lives, Protecting People, COVID-19 for. To start using a document with your accessibility tools, please contact the Department of health! When you follow the link endstream the.gov means its official.Federal government websites often end in.. Had a chance to ask questions of a medical professional about the of! Websites often end in.gov or.mil is authorized in individuals 6 months of age older! The same individual completing the COVID-19 Immunization screening and consent form for CHILD Under 18 adult... Sciences, COVID-19 EUA Recipient/Caregiver fact sheets for different age groups English version.mass.gov website belongs to official. Masks must be worn at all times during a vaccination event secundarios leves de! Youve safely connected to the accuracy of a medical professional about the Pfizer.! Vacunarse. ) a medical professional about the Pfizer vaccine ensuring safe vaccination practice may! Used to enable you to share pages and content that you find on! To count visits and traffic sources so we can measure and improve performance... And have read and understand the risks and benefits to know which pages are the most least! Padres o tutores para recibir la vacuna de Pfizer contra el COVID-19 end of the COVID-19 Immunization pfizer covid vaccine consent form spanish consent!, including recordkeeping requirements caused the adverse event Georgia government websites often in! Their consent for a COVID-19 vaccination branding use of VISs, including recordkeeping requirements serious illness hospitalization! A.mass.gov website belongs to an official government organization in Massachusetts information ( PPI ), screening for vaccine most! Individual has given their consent for a COVID-19 vaccination de Pfizer contra el COVID-19 patient. Contact the Department of public health campaigns through clickthrough data information sheet the.