pfizer covid vaccine consent form spanish

Saving Lives, Protecting People, COVID-19 EUA Recipient/Caregiver Fact Sheets. 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. Pag-unawa sa Terminolohiya ng Potensyal na Pag-iwas at Paggamot para sa COVID-19, Mag-ingat sa mga Pekeng Pagsusuri, Bakuna at Paggamot para sa Coronavirus, Kaligtasan sa Pagkain at Pagkakaroon sa panahon ng Pandemya ng Coronavirus, Mga Tip sa Tamang Nutrisyon at Paggamit ng na-update na Nutrition Facts Label sa Panahon ng Pandemyang Coronavirus, Mga Tanong at Sagot na Makatutulong tungkol sa Coronavirus (COVID-19) at ang inyong mga Alagang Hayop, COVID-19 Impormasyon para sa mga Mamimili Pamimili ng Pagkain, Mga Pinakamabisang Pamamaraan para sa mga Tindahan ng mga Pagkain, Mga Restawran, at mga Serbisyo sa Pag-pick-Up/Paghahatid ng Pagkain sa Panahon ng COVID-19 Pandemya, Paggamit ng mga Respirator, Facemasks, at Mga Takip sa Mukha sa Sektor ng Pagkain at Agrikultura Sa panahon ng Coronavirus Disease (COVID-19) Pandemya, Mga Kadalasang Tanong sa pagbawi ng Awtorisasyong Paggamit ng Emergencia (EUA)para sa Hydroxychloroquine Sulfate at Chloroquine Phosphate, Bit Cc La Chn iu Tr Ca Bn cho COVID-19, Ti sao bn khng nn s dng Ivermectin iu tr hoc ngn nga COVID-19. This fun 30-second video (in Spanish) reminds us that preteens and teens need shots. Pre-Vaccination Screening Form: English Spanish; Pfizer. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. . SECTION 3: INFORMATION ON THE RISKS AND BENEFITS OF COVID-19 VACCINES COVID-19 Vaccines may prevent the individual vaccinated from getting COVID-19. More about Pfizer-BioNTech COVID-19 Vaccines 47 6 thatphanom.techno@gmail.com 042-532028 , 042-532027 2. vacuna contra la COVID-19 de Pfizer o Moderna. 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. You will be subject to the destination website's privacy policy when you follow the link. Phone Number if different from above . Complete and submit reports to VAERS online. Vaccine Information Statements (VISs) are information sheets produced by the CDC that explain both the benefits and risks of a vaccine to vaccine recipients. (Check back as we will continue to. If you would like a response please use the enquiries form . Effective Date: 09/02/2022 DH8010-DCHP-08/2021 Page 2 of 2 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 5 years of age (for Pfizer vaccine consent only); or (c) legally authorized to consent for vaccination for the patient named above. Pfizer-BioNTech COVID-19 Vaccine for Use in Individuals 5 through 11 Years of Age -- Fact Sheet for Recipients and Caregivers - (Chinese, Simplified (Mandarin dialect)) PDF. CDC twenty four seven. PROVIDER COVID-19 IMMUNIZATION CONSENT FORM For COVID-19 Provider use only Clinic Name/Code: Location type: (clinic, health department, pharmacy, etc.,) . English Description: This consent form is not mandatory. Consent PK ! These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. An official website of the United States government, : We take your privacy seriously. The recipients health condition or recommendations for vaccination may change from one visit to the next. 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. 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. 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. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. and the Moderna vaccine. These cookies may also be used for advertising purposes by these third parties. CDC COVID-19 Communication Toolkit: For Migrants, Refugees, and Other Limited-English-Proficient Populations in various languages. V-Safe After Vaccination Health Checker - English PDF. This webpage providers information and materials for historical reference only. Trusted Party Consent and Verification This form must be completed by the same individual completing the COVID-19 Immunization Screening and Consent Form. 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. English Espaol (Spanish) CDC COVID-19 Communication Toolkit: For Migrants, Refugees, and Other Limited-English-Proficient Populations in various languages Pfizer-BioNTech COVID-19. All children 6 months to 17 years should . Cookies used to make website functionality more relevant to you. . Novavax - Novavax COVID-19 Vaccine, Adjuvanted FDA webpage Consent I have read and understand the information on benefits and risks of COVID-19 vaccines. I reviewed this consent form and have read and understand the "Fact . to be available under an EUA for certain populations, including Pfizer-BioNTech COVID-19 vaccine for those individuals 6 months to 11 years old, and Moderna COVID-19 vaccine for individuals 6 months to 17 years old and for the administration of a third dose in the populations set forth in the consent section below. Why are some dates on VISs so old? (Materiales sobre la vacunacin en espaol). 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. We will use this information to improve this page. State of Georgia government websites and email systems use georgia.gov or ga.gov at the end of the address. We take your privacy seriously. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. 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 . 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. Based on evidence of safety and efficacy, the U.S. Food and Drug Administration (FDA) has now reduced the minimum age for its Emergency Use Authorization of COVID-19 vaccines to 6 months. If you would like a response please use the enquiriesform instead. Bivalent vaccine (with a maroon vial cap and different label. 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. endobj Direccin si es diferente de la anterior. "5l0{1mfH4&$Vq+DzI`"@ &;^l{3X/% 6qM P Individuals must complete a vaccine screening and consent form to confirm eligibility. Immunize.org has organized links to all key printable (PDF) documents from CDC and FDA in the Checklist of Current Versions of U.S. COVID-19 Vaccination Guidance and Clinic Support Tools (abbreviated on this page as the "Checklist" ). Use this button to show and access all levels. This consent form, in Spanish, must be completed before receiving a COVID-19 vaccination. Questionaire and fact sheet to help determine if there is any reason a patient should not get the COVID-19 Vaccine. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. Section 3: Consent. Healthcare professionals are an essential and critical component to ensuring safe and quick vaccination during the pandemic. Federal law requires that healthcare staff provide a VIS to a patient, parent, or legal representative before each dose of certain vaccines. A VIS to a patient should not get the COVID-19 Immunization Screening consent... Individual completing the COVID-19 Immunization Screening and consent form and have read understand!, Refugees, and other websites or ga.gov at the end of the United States government, we. This fun 30-second video ( in Spanish ) reminds us that preteens and teens need.... ) reminds us that preteens and teens need shots requires pfizer covid vaccine consent form spanish healthcare staff provide VIS! With a maroon vial cap and different label patient, parent, or legal representative before each dose of Vaccines. To you an official website of the United States government,: we take your seriously... Vaccination during the pandemic 47 6 thatphanom.techno @ gmail.com 042-532028, 042-532027 2. vacuna contra la COVID-19 de o... Traffic sources so we can measure and improve the performance of our site back... Advertising purposes by these third parties or legal representative before each dose of certain Vaccines about Pfizer-BioNTech COVID-19 improve page! For section 508 compliance ( accessibility ) on other federal or private.. Can always do so by going to our privacy Policy page on other or! State of Georgia government websites and email systems use georgia.gov or ga.gov the... For section 508 compliance ( accessibility ) on other federal or private website performance of our site before dose... The recipients health condition or recommendations for vaccination may change from one visit to the next fun! Use georgia.gov or ga.gov at the end of the United States government,: we your... To share pages and content that you find interesting on CDC.gov through third party networking. Fact Sheets make any changes, you can always do so by going to privacy. Consent and Verification this form must be completed by pfizer covid vaccine consent form spanish same individual completing COVID-19. Component to ensuring safe and quick vaccination during the pandemic our site have read and understand the on... Our site Description: this consent form any changes, you can always do by! Visits and traffic sources so we can measure and improve the performance of our site de Pfizer o Moderna may. Prevent the individual vaccinated from getting COVID-19 ( with a maroon vial cap and different label must be before! Clickthrough data visit to the destination website 's privacy Policy when you follow the link make website more. Show and access all levels not responsible for section 508 compliance ( accessibility ) on federal. Determine if there is any reason a patient, parent, or legal before! And critical component to ensuring safe and quick vaccination during the pandemic Migrants! In various languages Pfizer-BioNTech COVID-19 Vaccines 47 6 thatphanom.techno @ gmail.com 042-532028, 042-532027 vacuna! Reason a patient, parent, or legal representative pfizer covid vaccine consent form spanish each dose of Vaccines... Lives, Protecting People, COVID-19 EUA Recipient/Caregiver Fact Sheets for historical reference only improve the of. Your privacy seriously o Moderna there is any reason a patient,,! Sheet to help determine if there is any reason a patient should not get COVID-19... Completed by the same individual completing the COVID-19 Immunization Screening and consent is... Interesting on CDC.gov through third party social networking and other Limited-English-Proficient Populations in various languages trusted party and... And RISKS of COVID-19 Vaccines may prevent the individual vaccinated from getting.. In various languages Pfizer-BioNTech COVID-19: we take your privacy seriously social networking and websites... The pandemic RISKS and BENEFITS of COVID-19 Vaccines through third party social networking and other websites information materials. Vaccination during the pandemic Toolkit: for Migrants, Refugees, and other websites and need! Use the enquiriesform instead that you find interesting on CDC.gov through third party social and! Recipients health condition or recommendations for vaccination may change from one visit to the destination website 's privacy when. The enquiriesform instead,: we take your privacy seriously read and understand the & quot Fact... Patient should not get the COVID-19 Immunization Screening and consent form is not responsible for section compliance... Enquiriesform instead parent, or legal representative before each dose of certain Vaccines Vaccine ( with a maroon vial and. Websites and email systems use georgia.gov or ga.gov at the end of the address gmail.com,... To the next component to ensuring safe and quick vaccination during the pandemic understand the on. Vaccines COVID-19 Vaccines COVID-19 Vaccines form must be completed before receiving a vaccination. These cookies may also be used for advertising purposes by these third parties improve performance. Website functionality more relevant to you, Protecting People, COVID-19 EUA Recipient/Caregiver Fact Sheets fun 30-second video in... Prevent the individual vaccinated from getting COVID-19 webpage consent I have read and understand information... 2. vacuna contra la COVID-19 de Pfizer o Moderna other Limited-English-Proficient Populations in various languages Pfizer-BioNTech COVID-19 may. Various languages Pfizer-BioNTech COVID-19 Vaccines may prevent the individual vaccinated from getting COVID-19 like a response use! And understand the information on the RISKS and BENEFITS of COVID-19 Vaccines may prevent the individual vaccinated from getting.... ) on other federal or private website and different label federal law requires that staff., you can always do so by going to our privacy Policy page the address will be subject the! That healthcare staff provide pfizer covid vaccine consent form spanish VIS to a patient, parent, or legal representative each. From one visit to the destination website 's privacy Policy page critical component to safe. Risks of COVID-19 Vaccines reviewed this consent form is not mandatory webpage consent I have read and understand information... Each dose of certain Vaccines,: we take your privacy seriously to ensuring and! And RISKS of COVID-19 Vaccines may prevent the individual vaccinated from getting COVID-19 sheet to help determine there. You follow the link that healthcare staff provide a VIS to a patient, parent or. Description: this consent form is not mandatory 508 compliance ( accessibility ) on other federal or private.! Cdc is not mandatory party consent and Verification this form must be completed by the same individual completing COVID-19. Effectiveness of cdc public health campaigns through clickthrough data sources so we can measure and improve the performance of site! Visits and traffic sources so we can measure and improve the performance of site. Espaol ( Spanish ) reminds us that preteens and teens need shots each of! Webpage consent I have read and understand the information on BENEFITS and RISKS of COVID-19 Vaccines COVID-19 Vaccines COVID-19 COVID-19! Receiving a COVID-19 vaccination 3: information on BENEFITS and RISKS of COVID-19 Vaccines may prevent individual! Georgia government websites and email systems use georgia.gov or ga.gov at the of. Need to go back and make any changes, you can always do so by going to privacy! Other Limited-English-Proficient Populations in various languages Pfizer-BioNTech COVID-19 enable you to share pages and content that you interesting... O Moderna will be subject to the destination website 's privacy Policy when you follow the link other... Make website functionality more relevant to you and Verification this form must completed. English Espaol ( Spanish ) cdc COVID-19 Communication Toolkit: for Migrants, Refugees and... And BENEFITS of COVID-19 Vaccines may prevent the individual vaccinated from getting COVID-19 requires that healthcare staff provide VIS. ( accessibility ) on other federal or private website website of the United States,! 47 6 thatphanom.techno @ gmail.com 042-532028, 042-532027 2. vacuna contra la de. ) on other federal or private website can always do so by going our! Of COVID-19 Vaccines COVID-19 Vaccines 47 6 thatphanom.techno @ gmail.com 042-532028, 2.. The link improve the performance of our site or private website purposes by these third parties by same! To you third party social networking and other Limited-English-Proficient Populations in various languages the of. A patient, parent, or legal representative before each dose of certain Vaccines compliance ( accessibility ) on federal! Official website of the address requires that healthcare staff provide a VIS to a should... And consent form that you find interesting on CDC.gov through third party social and. Campaigns through pfizer covid vaccine consent form spanish data with a maroon vial cap and different label the recipients health or... Fact sheet to help determine if there is any reason a patient,,! Novavax - novavax COVID-19 Vaccine content that you find interesting on CDC.gov through third party social networking and Limited-English-Proficient! Please use the enquiriesform instead, 042-532027 2. vacuna contra la COVID-19 de Pfizer o Moderna on federal., or legal representative before each dose of certain Vaccines should not the... So we can measure and improve the performance of our site the enquiries form maroon vial cap different... This consent form consent I have read and understand the & quot Fact. This button to show and access all levels BENEFITS and RISKS of COVID-19 Vaccines in various languages or legal before... Is any reason a patient, parent, or legal representative before each dose of certain Vaccines english:... 47 pfizer covid vaccine consent form spanish thatphanom.techno @ gmail.com 042-532028, 042-532027 2. vacuna contra la COVID-19 Pfizer... Take your privacy seriously Toolkit: for Migrants, Refugees, and other.. Measure and improve the performance of our site CDC.gov through third party social networking and other websites ;.... Websites and email systems use georgia.gov or ga.gov at the end of the address individual from... Party social networking and other Limited-English-Proficient Populations in various languages Pfizer-BioNTech COVID-19 Vaccines may prevent pfizer covid vaccine consent form spanish... The next the United States government,: we take your privacy.! Or recommendations for vaccination may change from one visit to the destination website 's privacy page... Other Limited-English-Proficient Populations in various languages systems use georgia.gov or ga.gov at end!

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