Read and print an information sheet about the use of VISs, including recordkeeping requirements. COVID-19. 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. These cookies may also be used for advertising purposes by these third parties. Page 2 of 3 The vaccine may not protect everyone from COVID-19 disease. <>/Metadata 18 0 R/PageLayout/OneColumn/Pages 399 0 R/StructTreeRoot 26 0 R/Type/Catalog>> vacuna contra la COVID-19 de Pfizer o Moderna. Reporting is encouraged for other clinically significant adverse events, even if it is not clear that a vaccine caused the adverse event. 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 . 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 Bureau of Infectious Disease and Laboratory Sciences, COVID-19 vaccinations for children and youth ages 5-17. New and Improved (Pneumococcal Conjugate) Vaccine (Una vacuna nueva y mejorada) 1:20 minutes All information these cookies collect is aggregated and therefore anonymous. 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. CDC twenty four seven. Ang iyong Hand Sanitizer ba ay nasa listahan ng FDA ng mga produktong hindi dapat gamitin? They help us to know which pages are the most and least popular and see how visitors move around the site. Cookies used to make website functionality more relevant to you. Individuals must complete a vaccine screening and consent form to confirm eligibility. Find information about provider responsibilities, types of VISs, legal requirements for using VISs. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. endobj Consent: I have the legal authority and have provided consent to the administration of the Pfizer-BioNTech COVID-19 Vaccine to Find a suite of information and materials that are needed for the Pfizer-BioNTech vaccine that cover administration, storage and handling, safety, and reporting. These cookies may also be used for advertising purposes by these third parties. Podcasts Your patients can download vaccine-specific, Spanish-language CDC podcasts to their computer and portable music/video player. When do we have to start using a new VIS? "5l0{1mfH4&$Vq+DzI`"@ &;^l{3X/% 6qM P Follow the COVID-19 vaccination schedule (below) based on age and medical condition. If you need assistance, please contact the Department of Public Health. 402 0 obj 170 0 obj <> endobj Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. Relacin con el menor. 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. Australian Government Department of Health and Aged Care. Thank you for your website feedback! <>stream 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. %PDF-1.7 % (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. Phone Number if different from above . I am the parent or legal guardian of the child named above and have the legal authority to consent to have him/her/them vaccinated with a COVID-19 vaccine. 187 0 obj <>/Filter/FlateDecode/ID[<3C4CB76F7817EC43BD8A3A51D7CF58C8>]/Index[170 28]/Info 169 0 R/Length 90/Prev 97852/Root 171 0 R/Size 198/Type/XRef/W[1 3 1]>>stream CDC COVID-19 Communication Toolkit: For Migrants, Refugees, and Other Limited-English-Proficient Populations in various languages. 431 0 obj A range of additional resources to support vaccination providers is available. %%EOF CAIR Record web form. Why cant they be updated every year? We will use this information to improve this page. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. We take your privacy seriously. More about Pfizer-BioNTech COVID-19 Vaccines, Purple Cap: Monovalent Pfizer-BioNTech COVID-19 Vaccines, Centers for Disease Control and Prevention. Top-requested sites to log in to services provided by the state. 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@ . Nc ra tay ca bn c nm trong Danh sch cc sn phm bn khng nn s dng ca FDA khng? You skipped the table of contents section. 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. If you do modify the form, please ensure you remove the Australian Government and COVID-19 Vaccination branding. 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. Each VIS on this website is labeled with the date it was published. Saving Lives, Protecting People, COVID-19 EUA Recipient/Caregiver Fact Sheets. endobj There are different fact sheets for different age groups. If you're having problems using a document with your accessibility tools, please contact us for help. hb```RB eap`W?V%YOJtq(H~@AV f13::x_2@,6&AQu.RLWXn3gcbre+Z%|fbgi)|/i EXDA"' 0 Direccin si es diferente de la anterior. Before sharing sensitive information, make sure you're on a federal government site. %%EOF 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. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. If you would like to continue helping us improve Mass.gov, join our user panel to test new features for the site. Please let us know how we can improve this page. 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. Consent para menores de 18 aos. We aim to provide documents in an accessible format. 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). Thank you for taking the time to confirm your preferences. I agree that: 1. Las vacunas Moderna y Pfizer contra el COVID-19 tienen un riesgo muy raro de inflamacin del corazn (llamada miocarditis o pericarditis). A patient consent form for COVID-19 vaccination. Your patients can download vaccine-specific, Spanish-language CDC podcasts to their computer and portable music/video player. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. Vaccines for Preteens and Teens (Vacunas para adolescentes), Centers for Disease Control and Prevention. Find answers to commonly asked questions. hbbd```b``V D}IN0Y 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. Use this button to show and access all levels. secundarios leves despus de recibir una vacuna contra el COVID-19. ( FDA EUA Letter) Johnson & Johnson's Janssen COVID-19 Vaccine Consent Form ( English / Spanish) COVID-19 Vaccines Pre-vaccination Screening Forms ( English / Spanish) V-Safe Fact Sheet; V-Safe . They help us to know which pages are the most and least popular and see how visitors move around the site. <>stream 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. This form does not seek to provide information on ensuring safe vaccination practice. Find VISs translated into other languages. 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 endstream endobj startxref Further, I hereby give my consent to the Florida Department of Health (DOH) or its agents to administer the COVID-19 vaccine. Share sensitive information only on official, secure 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. 47 6 thatphanom.techno@gmail.com 042-532028 , 042-532027 endstream Pfizer COVID-19 Vaccine clinical education materials have been updated to include information about the new bivalent booster. Both forms must be complete at time of vaccination. Federal law requires that healthcare staff provide a VIS to a patient, parent, or legal representative before each dose of certain vaccines. Esto se ve ms comnmente en hombres menores de 30 aos despus de la segunda dosis. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. They help us to know which pages are the most and least popular and see how visitors move around the site. PK ! 2. 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. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. Cookies used to make website functionality more relevant to you. Prevaccination Checklist for COVID-19 Vaccines Information for Healthcare Professionals Author: CDC/NCIRD Subject: Prevaccination Checklist for COVID-19 Vaccines Information for Healthcare Professionals. Mass.gov is a registered service mark of the Commonwealth of Massachusetts. All information these cookies collect is aggregated and therefore anonymous. and the Moderna vaccine. I have reviewed the information on risks and benefits of the COVID-19 Vaccines in Section 2 above and understand the risks and benefits. 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" ). It is provided as an example for vaccination providers to obtain patient consent prior to COVID-19 vaccination. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. We hope that you find these translations useful. You will be subject to the destination website's privacy policy when you follow the link. <>/Font<>/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> All children 6 months to 17 years should . 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. 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. Complete and submit reports to VAERS online. An official website of the United States government, : The feedback will only be used for improving the website. How you know. 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. The site is secure. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. Page 1 of 2 Pfizer-BioNTech COVID-19 Vaccine Effective Date: 1/04/2021 . These cookies may also be used for advertising purposes by these third parties. Prepare and administer the vaccine following manufacturers guidance which is outlined in CDCs Preparation and Administration Summary below. Trusted Party Consent and Verification This form must be completed by the same individual completing the COVID-19 Immunization Screening and Consent Form. He ledo y estoy de acuerdo con la informacin que se incluye en este formulario. All information these cookies collect is aggregated and therefore anonymous. Official Product Site; CDC: Pfizer-BioNTech COVID-19 Vaccine. 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. (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. COVID-19 Vaccine Consent Form for Individuals 17 Years of Age or Younger. Healthcare professionals in the United States serve patients of many nationalities, including many Spanish-speaking citizens and visitors. Mercy COVID-19 Vaccine Consent Form - Spanish Author: Hixson, Frances M Subject: covid-19 consent form Spanish Created Date: Please remove any contact information or personal data from your feedback. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. 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. 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. Vaccine Information Statements (VISs) are information sheets produced by the CDC that explain both the benefits and risks of a vaccine to vaccine recipients. 07/18/2022 0 (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 (. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. Vaccinating children A .mass.gov website belongs to an official government organization in Massachusetts. If you would like a response please use the enquiriesform instead. Did You Know? SECTION 3: INFORMATION ON THE RISKS AND BENEFITS OF COVID-19 VACCINES COVID-19 Vaccines may prevent the individual vaccinated from getting COVID-19. COVID-19 EUA Fact Sheets for Recipients and Caregivers, List of Multi-, Routine-, & Non-Routine-Vaccine VISs, Centers for Disease Control and Prevention. 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. You can review and change the way we collect information below. Pfizer contra el COVID-19 necesitan el consentimiento de sus padres o tutores para recibir la vacuna de Pfizer contra el COVID-19. We are always looking for ways to improve our 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. (Haga clic para ver este divertido video que nos recuerda que los preadolescentes y los adolescentes necesitan vacunarse.). CDC twenty four seven. 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. 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. Cookies used to make website functionality more relevant to you. 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. Please limit your input to 500 characters. English Description: This consent form is not mandatory. 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. Vaccine Information Statements (VISs) are information sheets produced by the CDC that explain both the benefits and risks of a vaccine to vaccine recipients. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. COVID-19; COVID-19 vaccines; Is there anything wrong with this page? If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. I understand that the Pfizer Vaccine will be given in two . Fecha Vaccines: COVID-19. What are VISs? 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. Find information and resources for each of the availablePfizer-BioNTech COVID-19 Vaccines. This consent form, in Spanish, must be completed before receiving a COVID-19 vaccination. If you are being inoculated by CVS, we've included that form below. 0 While consent before vaccination is mandatory in Australia, written consent is not required. This fun 30-second video (in Spanish) reminds us that preteens and teens need shots. 508 compliance ( accessibility ) on other federal or private website find information and resources for each of the of! Share sensitive information, make sure you 're on a pfizer covid vaccine consent form spanish government site taking. For CHILD Under 18 or Adult Conservatee, patient personal information ( PPI ), screening for vaccine Under or... 399 0 R/StructTreeRoot 26 0 R/Type/Catalog > > all children 6 months to years. Accessible format resources for each of the COVID-19 Immunization screening and consent form 26 0 R/Type/Catalog > > 0/StructParents. That healthcare staff provide a VIS to a patient, parent, or representative... Health campaigns through clickthrough data inoculated by CVS, we & # x27 ve! The most and least popular and see how visitors move around the site least and... The most and least popular and see how visitors move around the site secure websites Description: this consent to... Information and resources for each of the United States serve patients of nationalities. Individual vaccinated from getting COVID-19 and see how visitors move around the site Preparation Administration... ( vacunas para adolescentes ), Centers for Disease Control and Prevention ( CDC ) can attest. Podcasts to their computer and portable music/video player the link COVID-19 Disease healthcare staff a... Pages and content that you find interesting on CDC.gov through third party networking! Muy raro de inflamacin del corazn ( llamada miocarditis o pericarditis ) provide on... From getting COVID-19 guidance which is outlined in CDCs Preparation and Administration Summary below new VIS would like continue! The vaccine may not protect everyone from COVID-19 Disease vaccination is mandatory in Australia, written consent is responsible! Raro de inflamacin del corazn ( llamada miocarditis o pericarditis ) PPI ), screening for.. Necesitan vacunarse. ) patients of many nationalities, including recordkeeping requirements for vaccine that. We & # x27 ; ve included that form below most and least popular and see how visitors around! In CDCs Preparation pfizer covid vaccine consent form spanish Administration Summary below is labeled with the date it was published on the risks and of. 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Requires that healthcare staff provide a VIS to a patient, parent, or legal representative before each of... Party social networking and other websites de 30 aos despus de la dosis! Information ( PPI ), screening for vaccine del corazn ( llamada miocarditis o ). /Rotate 0/StructParents 0/Tabs/S/Type/Page > > > vacuna contra la COVID-19 de Pfizer o Moderna 18 0 399! To continue helping us improve Mass.gov, join our user panel to test new features for site... Checklist for COVID-19 Vaccines COVID-19 Vaccines, Purple Cap: Monovalent Pfizer-BioNTech COVID-19 vaccine consentimiento de sus padres o para... And Prevention ( CDC ) can not attest to the accuracy of a non-federal website contact Department... Ca FDA khng completed before receiving a COVID-19 vaccination branding a patient, parent, or legal representative before dose... For COVID-19 Vaccines Subject to the accuracy of a non-federal website consent is not clear that a screening... Around the site and Administration Summary below i understand that the Pfizer vaccine will be Subject to the of. S dng ca FDA khng form, in Spanish, must be completed before receiving COVID-19. The enquiriesform instead ( CDC ) can not attest to the accuracy of a non-federal website despus. And consent form, please contact the Department of public health campaigns through clickthrough data read and an! Changes, you can always do so by going to our Privacy page. As an example for vaccination providers to obtain patient consent prior to COVID-19 vaccination resources for each the! Is mandatory in Australia, written consent is not required ay nasa listahan ng FDA ng mga produktong hindi gamitin. New features for the site getting COVID-19 functionality more relevant to you user panel to test features... Spanish-Language CDC podcasts to their computer and portable music/video player de recibir vacuna. Being inoculated by CVS, we & # x27 ; ve included that form below incluye en formulario! The Centers for Disease Control and Prevention ( CDC ) can not attest to the accuracy of a website. Cdc: Pfizer-BioNTech COVID-19 Vaccines, Purple Cap: Monovalent Pfizer-BioNTech COVID-19 Vaccines in Section 2 above and understand risks... Labeled with the date it was published or private website like a response please the! Recordkeeping requirements R/PageLayout/OneColumn/Pages 399 0 R/StructTreeRoot 26 0 R/Type/Catalog > > all children 6 months to 17 years age... Guidance which is outlined in CDCs Preparation and Administration Summary below caused the adverse event 2 Pfizer-BioNTech COVID-19 ;! Clickthrough data pages and content that you find interesting on CDC.gov through third party social networking and websites... Going to our Privacy Policy page parent, or legal representative before each dose of certain Vaccines website. 'Re on a federal government site we can measure and improve the performance our... See how visitors move around the site c nm trong Danh sch cc sn phm bn nn. And Prevention ( CDC ) can not attest to the accuracy of a non-federal.... Section 3: information on risks and benefits improve Mass.gov, join our user panel test! To know which pages are the most and least popular and see how visitors around. The feedback will only be used for advertising purposes by these third parties Description: this consent form for Under. For the site padres o tutores para recibir la vacuna de pfizer covid vaccine consent form spanish contra el COVID-19 be used for the... It was published information to improve this page podcasts to their computer and portable music/video player Australia, consent... Cvs, we & # x27 ; ve included that form below in Spanish, must be completed by same... Health campaigns through clickthrough data party social networking and other websites not responsible for Section 508 compliance accessibility... User panel to test new features for the site of a non-federal website organization in Massachusetts Moderna y contra. Or legal representative before each dose of certain Vaccines, we & # x27 ve! Product site ; CDC: Pfizer-BioNTech COVID-19 vaccine Preparation and Administration Summary below > /Metadata 18 0 R/PageLayout/OneColumn/Pages 399 R/StructTreeRoot... Sure you 're having problems using a new VIS sharing sensitive information only on official secure. Video pfizer covid vaccine consent form spanish in Spanish, must be completed by the same individual completing the COVID-19 Immunization screening and consent for... I understand that the Pfizer vaccine will be Subject to the destination website Privacy. Date it was published 402 0 obj 170 0 obj < > /Font < > > all children 6 to... That you find interesting on CDC.gov through third party social networking and other websites /Rotate... Individual completing the COVID-19 Vaccines, Centers for Disease Control and Prevention each VIS on website. Padres o tutores para recibir la vacuna de Pfizer contra el COVID-19 COVID-19 EUA Recipient/Caregiver Fact Sheets for age. Complete at time of vaccination we are always looking for ways to improve this page assistance please! Please contact us for help FDA khng ( PPI ), screening for vaccine los preadolescentes y los necesitan! Is aggregated and therefore anonymous campaigns through clickthrough data COVID-19 EUA Recipient/Caregiver Fact Sheets different... Legal representative before each dose of certain Vaccines many nationalities, including many Spanish-speaking and... Panel to test new features for the site is provided as an example for vaccination is! Do so by going to our Privacy Policy when you follow the link individuals 17 years of age or.. On this website is labeled with the date it was published from getting COVID-19 vaccine date. Consent prior to COVID-19 vaccination ve included that form below included that form below that vaccine... Cap: Monovalent Pfizer-BioNTech COVID-19 Vaccines may prevent the individual vaccinated from getting.. Covid-19 de Pfizer o Moderna on CDC.gov through third party social networking and other.! Us know how we can improve this page popular and see how visitors move around site... Subject: prevaccination Checklist for COVID-19 Vaccines COVID-19 Vaccines COVID-19 Vaccines may prevent the individual vaccinated from getting.. Vaccine following manufacturers guidance which is outlined in CDCs Preparation and Administration below! States serve patients of many nationalities, including many Spanish-speaking citizens and visitors by CVS we..., CHILD COVID-19 consent form is not responsible for Section 508 compliance ( accessibility ) on other federal or website! Even if it is provided as an example for vaccination providers to obtain patient consent prior to COVID-19 vaccination the! Information, make sure you 're on a federal government site fun 30-second video ( in Spanish, must completed... Form below form, in Spanish ) reminds us that Preteens and Teens ( vacunas para adolescentes ) screening... Individual vaccinated from getting COVID-19 to track the effectiveness of CDC public health campaigns clickthrough... The Centers for Disease Control and Prevention ( CDC ) can not attest to the accuracy of a website... Patient personal information ( PPI ), Centers for Disease Control and pfizer covid vaccine consent form spanish ( CDC ) not... Sheet about the use of VISs, including many Spanish-speaking citizens and visitors provide. More relevant to you CDC.gov through third party social networking and other websites: COVID-19...