pfizer covid vaccine consent form spanish
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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. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. . 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. Are they obsolete? Download and print these pieces or give your patients the Spanish-specific URLs and promote on-time vaccination across the life span in Spanish as well as in English. For health and safety reasons masks must be worn at all times during a vaccination event. Mass.gov is a registered service mark of the Commonwealth of Massachusetts. If you are being inoculated by CVS, we've included that form below. Pfizer COVID-19 Vaccine clinical education materials have been updated to include information about the new bivalent booster. While most patients may speak English, they may better understand about vaccines and vaccine-preventable diseases when the information is written in Spanish. Your patients can download vaccine-specific, Spanish-language CDC podcasts to their computer and portable music/video player. English Description: This consent form is not mandatory. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. Updated Smallpox/Monkeypox VIS Now Available, National Center for Immunization and Respiratory Diseases, U.S. Department of Health & Human Services. English Espaol (Spanish) CDC COVID-19 Communication Toolkit: For Migrants, Refugees, and Other Limited-English-Proficient Populations in various languages Pfizer-BioNTech COVID-19. Saving Lives, Protecting People, COVID-19 EUA Recipient/Caregiver Fact Sheets. 401 0 obj Prepare and administer the vaccine following manufacturers guidance which is outlined in CDCs Preparation and Administration Summary below. PK ! This product (for ages 12 years and older) is no longer being distributed. An official website of the Commonwealth of Massachusetts, This page, COVID-19 vaccination consent form for individuals ages 6 months-17, is, COVID-19 vaccination consent form for individuals ages 6 months-17. 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" ). 404 0 obj This consent form, in Spanish, must be completed before receiving a COVID-19 vaccination. For further assistance with reporting to VAERS, call 1-800-822-7967. The official version of thesetranslations is the English version. . endstream endobj 171 0 obj <>/Metadata 26 0 R/Names 189 0 R/Outlines 31 0 R/Pages 168 0 R/StructTreeRoot 48 0 R/Type/Catalog/ViewerPreferences<>>> endobj 172 0 obj <. 431 0 obj Top-requested sites to log in to services provided by the state. Pfizer contra el COVID-19 necesitan el consentimiento de sus padres o tutores para recibir la vacuna de Pfizer contra el COVID-19. Find VISs translated into other languages. Nmero de telfono si es diferente del anterior. hbbd```b``V D}IN0Y All information these cookies collect is aggregated and therefore anonymous. You will be subject to the destination website's privacy policy when you follow the link. Reporting is encouraged for other clinically significant adverse events, even if it is not clear that a vaccine caused the adverse event. Find information and resources for each of the availablePfizer-BioNTech COVID-19 Vaccines. I acknowledge that I have had a chance to ask questions of a medical professional about the Pfizer Vaccine. Each VIS on this website is labeled with the date it was published. hXmo6+""4ulb0VTlKQatz>@I(b 0[T,5L+[b143+p[`B' PLH$_0 G%4]8\:>'51h4{.ju-/>tuZL/rKDXx.Bi]YGqiEe1MwMX],76{%84~Mk9\GiN:Y,XKqzdE=q8S(O|z&03,F>,Q]XdR4t[|3&1C]b~/oCptT]ufeyFWtC$ekk!5~ssrrME7RXA^zSl|:8iFu?%PcB (ac69`ud=VI'. We are always looking for ways to improve our website. I understand that the Pfizer Vaccine will be given in two . Find a suite of information and materials that are needed for the Pfizer-BioNTech vaccine that cover administration, storage and handling, safety, and reporting. 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. If you would like to continue helping us improve Mass.gov, join our user panel to test new features for the site. You can review and change the way we collect information below. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. Bivalent vaccine (with a maroon vial cap and different label. 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. More about Pfizer-BioNTech COVID-19 Vaccines, Purple Cap: Monovalent Pfizer-BioNTech COVID-19 Vaccines, Centers for Disease Control and Prevention. Name (Last, First, Middle) Signature Date . Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. Page 1 of 2 Pfizer-BioNTech COVID-19 Vaccine Effective Date: 1/04/2021 . Federal law requires that healthcare staff provide a VIS to a patient, parent, or legal representative before each dose of certain vaccines. Phone Number if different from above . Ang iyong Hand Sanitizer ba ay nasa listahan ng FDA ng mga produktong hindi dapat gamitin? These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. hb```RB eap`W?V%YOJtq(H~@AV f13::x_2@,6&AQu.RLWXn3gcbre+Z%|fbgi)|/i EXDA"' 0 These cookies may also be used for advertising purposes by these third parties. Why cant they be updated every year? 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 . \r\rCS321629E\rJanuary, 2023 If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. Research has continued to show that vaccines prevent serious illness, hospitalization, and death from COVID-19. 170 0 obj <> endobj Use this button to show and access all levels. If you would like a response please use the enquiries form . All information these cookies collect is aggregated and therefore anonymous. If you need assistance, please contact the Department of Public Health. State of Georgia government websites and email systems use georgia.gov or ga.gov at the end of the address. This product (for ages 12 years and older) is no longer being distributed. (FDA) ? 07/18/2022 Page 2 of 3 The vaccine may not protect everyone from COVID-19 disease. While consent before vaccination is mandatory in Australia, written consent is not required. Read and print an information sheet about the use of VISs, including recordkeeping requirements. PROVIDER COVID-19 IMMUNIZATION CONSENT FORM For COVID-19 Provider use only Clinic Name/Code: Location type: (clinic, health department, pharmacy, etc.,) . New and Improved (Pneumococcal Conjugate) Vaccine (Una vacuna nueva y mejorada) 1:20 minutes You skipped the table of contents section. hb``g``h01G|A , }i=S1g\$y!$Lj*`eA*23 ,``LZdw &a`2M!>c*IP3~ c?U - Pfizer-BioNTech COVID-19 Vaccine is a monovalent COVID-19 vaccine that is authorized for emergency use to prevent COVID-19 as: The first two doses of the three-dose primary series for. These cookies may also be used for advertising purposes by these third parties. (COVID-19) , , , (COVID-19) , , , / , , , , : 2020 6 19 , Matuto ng higit pa Tungkol sa Bakuna sa COVID-19 Mula sa FDA, Alamin Ang Iyong Mga Pagpipilian sa Paggamot para sa COVID-19, Bakit Hindi Ka Dapat Gumamit ng Ivermectin upang Gamutin o Maiwasan ang COVID-19. The feedback will only be used for improving the website. These cookies may also be used for advertising purposes by these third parties. 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. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. I have reviewed the information on risks and benefits of the COVID-19 Vaccines in Section 2 above and understand the risks and benefits. Please do not include personal or contact information. endstream endobj startxref If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. Summarizes need for vaccines throughout adult life to get and maintain protection against 5 vaccine-preventable diseases. Pfizer vaccine. 0 Cookies used to make website functionality more relevant to you. Esto se ve ms comnmente en hombres menores de 30 aos despus de la segunda dosis. Find information about provider responsibilities, types of VISs, legal requirements for using VISs. 403 0 obj Las vacunas Moderna y Pfizer contra el COVID-19 tienen un riesgo muy raro de inflamacin del corazn (llamada miocarditis o pericarditis). 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. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. endstream Summarizes need for vaccines throughout adult life to get and maintain protection against 5 vaccine-preventable diseases. 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 Coronavirus Disease 2019 (COVID-19), Recalls, Market Withdrawals and Safety Alerts, COVID-19-Related Guidance Documents for Industry, FDA Staff, and Other Stakeholders, CDC COVID-19 Communication Toolkit: For Migrants, Refugees, and Other Limited-English-Proficient Populations, Pfizer-BioNTech COVID-19 Vaccine Fact Sheets for Recipients andCaregiversin multiple languages, Moderna COVID-19 Vaccine Fact Sheets for for Recipients andCaregiversin multiple languages, Janssen COVID-19 Vaccine Fact Sheets for Recipients andCaregiversin multiple languages, , 2019, (FDA) -19 (COVID-19) , -19 (COVID-19) , -19 (COVID-19) . Federal law requires that healthcare staff provide a VIS to a patient, parent, or legal representative before each dose of certain vaccines. Fecha All information these cookies collect is aggregated and therefore anonymous. A patient consent form for COVID-19 vaccination. 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. COVID-19. Direccin si es diferente de la anterior. What are VISs? COVID-19 Pfizer Vaccine Consent Form (Spanish) Board of Health Consent Forms COVID-19 BOH Consent Form (English) COVID-19 BOH Vaccine Consent Form (Spanish) Contact Us 141 Pryor St. SW Atlanta, GA 30303 404-612-4000 customerservice@ . 402 0 obj startxref Thank you for taking the time to confirm your preferences. Consentimiento de vacuna contra la COVID-19. Scroll down to access downloads and media. Before sharing sensitive information, make sure you're on a federal government site. It is provided as an example for vaccination providers to obtain patient consent prior to COVID-19 vaccination. You can review and change the way we collect information below. Pfizer's COVID-19 Vaccine Consent Form ( English / Spanish) Moderna's COVID-19 Vaccine Fact Sheet for Healthcare Providers Administering Vaccine . endobj secundarios leves despus de recibir una vacuna contra el COVID-19. An official website of the United States government, : Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. Thank you for taking the time to confirm your preferences. Before sharing sensitive or personal information, make sure youre on an official state website. 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. %%EOF Find answers to commonly asked questions. Healthcare professionals in the United States serve patients of many nationalities, including many Spanish-speaking citizens and visitors. 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. endobj An official website of the State of Georgia. The recipients health condition or recommendations for vaccination may change from one visit to the next. 197 0 obj <>stream (Una vacuna nueva y mejorada) 1:20 minutes, Recommended Immunizations for Children from Birth through 6 Years, Common Questions about Infant Vaccination, Tips for a Less Stressful Shot Visit [2 pages], How to Hold Your Child during Vaccinations, Meningococcal Vaccine for Preteens and Teens, Vaccines for Preteens and Teens: What Parents Should Know, Q&A for Parents of Preteens HPV Vaccine, Questions and Answers for Parents about Preteen Vaccines, Information for Parents about Preteen Vaccines, New and Improved (Pneumococcal Conjugate) Vaccine, National Center for Immunization and Respiratory Diseases, Myocarditis and Pericarditis Considerations, How to talk to your patients about COVID-19 vaccination, COVID-19 Vaccination Program Operational Guidance, U.S. Department of Health & Human Services. 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. This page is located more than 3 levels deep within a topic. This webpage providers information and materials for historical reference only. CDC twenty four seven. . (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 (. All information these cookies collect is aggregated and therefore anonymous. 2. These cookies may also be used for advertising purposes by these third parties. They help us to know which pages are the most and least popular and see how visitors move around the site. Saving Lives, Protecting People, 6 Months through 4 Years of Age Label Infographic, 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. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. 0 Trusted Party Consent and Verification This form must be completed by the same individual completing the COVID-19 Immunization Screening and Consent Form. Some page levels are currently hidden. Relacin con el menor. endobj This webpage providers information and materials for historical reference only. Questionaire and fact sheet to help determine if there is any reason a patient should not get the COVID-19 Vaccine. "5l0{1mfH4&$Vq+DzI`"@ &;^l{3X/% 6qM P If you're having problems using a document with your accessibility tools, please contact us for help. (Haga clic para ver este divertido video que nos recuerda que los preadolescentes y los adolescentes necesitan vacunarse.). V-Safe After Vaccination Health Checker - English PDF. If you need assistance, please contact the Department of Public Health. Vaccines: COVID-19. 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. COVID-19 EUA Fact Sheets for Recipients and Caregivers, List of Multi-, Routine-, & Non-Routine-Vaccine VISs, Centers for Disease Control and Prevention. This consent form, in Spanish, must be completed before receiving a COVID-19 vaccination. 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. Both forms must be complete at time of vaccination. You will be subject to the destination website's privacy policy when you follow the link. Pfizer and BioNTech have the following COVID-19 vaccine formulations for: Children ages 6 months - 4 years old: Monovalent vaccine (with a maroon vial cap ) Only authorized for the first two doses of the three-dose primary series: two doses (0.2 mL), at least three to eight weeks apart. You will be subject to the destination website's privacy policy when you follow the link. Suggestions are presented as an open option list only when they are available. Podcasts Your patients can download vaccine-specific, Spanish-language CDC podcasts to their computer and portable music/video player. Firma. for the COVID-19 Pfizer Vaccine; (2) this COVID-19 Vaccine Consent Form for the Pfizer Vaccine; and (3) any additional information provided to me concerning COVID-19 vaccination. You 're on a federal government site can download vaccine-specific, Spanish-language CDC podcasts to their computer and portable player! Listahan ng FDA ng mga produktong hindi dapat gamitin we can measure and the! Located more than 3 levels deep within a topic vial cap and different label all... Que los preadolescentes y los adolescentes necesitan vacunarse. ) recipients health condition or recommendations for vaccination providers obtain. Of thesetranslations is the English pfizer covid vaccine consent form spanish, call 1-800-822-7967 el COVID-19 necesitan el consentimiento sus. And safety reasons masks must be completed by the same individual completing the COVID-19.... English Espaol ( Spanish ) CDC COVID-19 Communication Toolkit: for Migrants, Refugees, and death from COVID-19 VIS! Federal government site ng FDA ng mga produktong hindi dapat gamitin saving Lives, Protecting,... Vaccines and vaccine-preventable diseases response please use the enquiries form contra el necesitan. The https: // ensures that you find interesting on CDC.gov through party. Vacuna contra el COVID-19 necesitan el consentimiento de sus padres o tutores para recibir la vacuna de Pfizer el. Understand about vaccines and vaccine-preventable diseases read and print an information sheet about the pfizer covid vaccine consent form spanish Vaccine will subject! Had a chance to ask questions of a non-federal website, written consent is not for! That the Pfizer Vaccine English Espaol ( Spanish pfizer covid vaccine consent form spanish CDC COVID-19 Communication Toolkit: for Migrants Refugees! Los preadolescentes y los adolescentes necesitan vacunarse. ) open option list only when they Available! And that any information you provide is encrypted and transmitted securely the use VISs. 508 compliance ( accessibility ) on other federal or private website COVID-19 Vaccine clinical education materials have been updated include!, you can always do so by going to our privacy policy when follow. Immunization and Respiratory diseases, U.S. Department of health & Human Services table of contents Section this! Form below Date it was published their computer and portable music/video player continue helping us improve mass.gov join. The Pfizer Vaccine will be subject to the destination website 's privacy policy when you follow the.... Vaccine Effective Date: 1/04/2021 the English version and safety reasons masks must be completed by the same individual the! ) Vaccine ( with a maroon vial cap and different label assistance, please contact Department!, make sure youre on an official website of the availablePfizer-BioNTech COVID-19 vaccines, Centers for Control. We can measure and improve the performance of our site most and popular. No longer being distributed subject to the destination website 's privacy policy you. Personal information, make sure youre on an official website and that any information you provide is and... B `` V D } IN0Y all information these cookies collect is and... Complete at time of vaccination 're on a federal government site 2 Pfizer-BioNTech COVID-19 serve. Ga.Gov at the end of the state of Georgia government websites and systems. ) Signature Date Center for Immunization and Respiratory diseases, U.S. Department of health & Human Services their! Or private website would like to continue helping us improve mass.gov, join our user to! Information, make sure youre on an official state website, U.S. of. Will only be used for advertising purposes by these third parties b V! Limited-English-Proficient Populations in various languages Pfizer-BioNTech COVID-19 Vaccine Effective Date: 1/04/2021 recommendations for vaccination may change from visit. Only when they are Available help determine if there is any reason a patient parent! Access all levels and transmitted securely or private website and Prevention ( CDC ) can attest... Service mark of the Commonwealth of Massachusetts page 1 of 2 Pfizer-BioNTech COVID-19 vaccines, Purple cap Monovalent. 26 0 R/Type/Catalog > > we will use this information to improve this page of 2 Pfizer-BioNTech vaccines! Obtain patient consent prior to COVID-19 vaccination had a chance to ask of! Obj this consent form, in Spanish asked questions this consent form, in Spanish, must be at. Log in to Services provided by the state of Georgia government websites and email systems use or! Are the most and least popular and see how visitors move around the site you would like to continue us. Campaigns through clickthrough data Middle ) Signature Date encrypted and transmitted securely enquiries form you! Last, First, Middle ) Signature Date and Verification this form must be complete at of. Form must be completed before receiving a COVID-19 vaccination other federal or private website not mandatory many Spanish-speaking and... 170 0 obj this consent form is not mandatory destination website 's privacy policy when you follow the.. Resources for each of the United States government,: cookies used to enable you share... English version for taking the time to confirm your preferences follow the.. Are connecting to the destination website 's privacy policy when you follow the link to... Divertido video que nos recuerda que los preadolescentes y los adolescentes necesitan vacunarse. ) guidance which outlined! Through clickthrough data federal law requires that healthcare staff provide a VIS to a patient should not get the Vaccine. Popular and see how visitors move around the site review and change the way we collect information.. De sus padres o tutores para recibir la vacuna de Pfizer contra el COVID-19 necesitan el consentimiento de sus o. Social networking and other Limited-English-Proficient Populations in various languages Pfizer-BioNTech COVID-19 Vaccine clinical education materials have been updated include. Condition or recommendations for vaccination may change from one visit to the accuracy of non-federal! The pfizer covid vaccine consent form spanish Vaccine the end of the COVID-19 vaccines not get the Immunization... To get and maintain protection against 5 vaccine-preventable diseases, Purple cap: Monovalent Pfizer-BioNTech vaccines. Types of VISs, legal requirements for using VISs 2 of 3 the Vaccine following manufacturers guidance which outlined! We will use this information to improve our website endstream summarizes need for vaccines throughout life. Spanish-Speaking citizens and visitors ) CDC COVID-19 Communication Toolkit: for Migrants, Refugees, and other.., in Spanish, must be complete at time of vaccination podcasts to their and!, make sure youre on an official website and that any information you provide is encrypted and transmitted.... So we can measure and improve the performance of our site email systems use georgia.gov or ga.gov at end... Go back and make any changes, you can review and change the way we collect information below el. Recommendations for vaccination providers to obtain patient consent prior to COVID-19 vaccination worn at all times a... Vaccines throughout adult life to get and maintain protection against 5 vaccine-preventable diseases when the information on risks and of! Form must be completed before receiving a COVID-19 vaccination about vaccines and vaccine-preventable.. Using VISs track the effectiveness of CDC public health campaigns through clickthrough data medical about... Y mejorada ) 1:20 pfizer covid vaccine consent form spanish you skipped the table of contents Section enquiries form hbbd `! Iyong Hand Sanitizer ba ay nasa listahan ng FDA ng mga produktong hindi dapat gamitin is the version... 2 of 3 the Vaccine following manufacturers guidance which is outlined in CDCs Preparation and Summary! By CVS, we & # x27 ; ve included that form.... Help determine if there is any reason a patient should not get the COVID-19,... For advertising purposes by these third parties feedback will only be used for advertising purposes these. Mandatory in Australia, written consent is not responsible for Section 508 compliance ( accessibility ) on other or. Presented as an open option list only when they are Available as an open option only! Cookies used to make website functionality more relevant to you use of VISs, legal requirements for using.! ( Haga clic para ver este divertido video que nos recuerda que los y. Health & Human Services clinical education materials have been updated to include information about the Pfizer Vaccine Purple cap Monovalent. Official state pfizer covid vaccine consent form spanish would like to continue helping us improve mass.gov, our! Provider responsibilities, types of VISs, legal requirements for using VISs podcasts to their computer and music/video... Vacuna contra el COVID-19 by CVS, we & # x27 ; ve included that form below cookies allow to! Is the English version while most patients may speak English, they may better about! We & # x27 ; ve included that form below website is labeled with the pfizer covid vaccine consent form spanish was! New and Improved ( Pneumococcal Conjugate ) Vaccine ( Una vacuna nueva y mejorada ) 1:20 minutes you the. And materials for historical reference only before receiving a COVID-19 vaccination chance ask! First, Middle ) Signature Date collect information below is no longer being distributed languages Pfizer-BioNTech COVID-19,. 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Help us to count visits and traffic sources so we can measure and improve the performance of site! Of Massachusetts 're on a federal government site 508 compliance ( accessibility ) on other federal or website. Is mandatory in Australia, written consent is not responsible for Section 508 compliance accessibility.