pfizer covid vaccine consent form spanish

hbbd```b``V D}IN0Y <>stream Vaccine information statements for Pfizer can be at www.cvdvaccine.com. Vaccines: COVID-19. Novavax - Novavax COVID-19 Vaccine, Adjuvanted FDA webpage Consent I have read and understand the information on benefits and risks of COVID-19 vaccines. The official version of thesetranslations is the English version. 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. Address if different from above . Find answers to commonly asked questions. 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. Did You Know? Federal law requires that healthcare staff provide a VIS to a patient, parent, or legal representative before each dose of certain vaccines. 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. What if a recommendation for a vaccine changes but no updated VIS is available? If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. For further assistance with reporting to VAERS, call 1-800-822-7967. para menores de 18 aos. Prevaccination Checklist for COVID-19 Vaccines Information for Healthcare Professionals Author: CDC/NCIRD Subject: Prevaccination Checklist for COVID-19 Vaccines Information for Healthcare Professionals. New and Improved (Pneumococcal Conjugate) Vaccine (Una vacuna nueva y mejorada) 1:20 minutes How you know. This consent form is not mandatory. Mass.gov is a registered service mark of the Commonwealth of Massachusetts. Are they obsolete? 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 skipped the table of contents section. <>/Font<>/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> There are different fact sheets for different age groups. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. This product (for ages 12 years and older) is no longer being distributed. Thank you for taking the time to confirm your preferences. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. ) or https:// means youve safely connected to the official website. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. When do we have to start using a new VIS? Phone Number if different from above . You can review and change the way we collect information below. State of Georgia government websites and email systems use georgia.gov or ga.gov at the end of the address. Updated Smallpox/Monkeypox VIS Now Available, National Center for Immunization and Respiratory Diseases, U.S. Department of Health & Human Services. Consent: I have the legal authority and have provided consent to the administration of the Pfizer-BioNTech COVID-19 Vaccine to An official website of the United States government, : vacuna contra la COVID-19 de Pfizer o Moderna. Fecha Pfizer vaccine. More about Pfizer-BioNTech COVID-19 Vaccines Healthcare professionals in the United States serve patients of many nationalities, including many Spanish-speaking citizens and visitors. 404 0 obj 94 [Content_Types].xml ( Qo0_Qn P= {IW/$mPtA{:gq]q)[(QdR(*,_-nr!WbC?J%FRc5eTZK Z \|Z5/'ACTSUBV.lfXVAxN)qU7\m8+$kQ*QC5OwU 5[]9xen2&a'$0H0_At9HBd:'u )"dAza|DQL(-I. If you are being inoculated by CVS, we've included that form below. Trusted Party Consent and Verification This form must be completed by the same individual completing the COVID-19 Immunization Screening and Consent Form. Cookies used to make website functionality more relevant to you. . Vaccine Information Statements (VISs) are information sheets produced by the CDC that explain both the benefits and risks of a vaccine to vaccine recipients. If you need assistance, please contact the Department of Public Health. Complete and submit reports to VAERS online. All information these cookies collect is aggregated and therefore anonymous. We take your privacy seriously. 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. Call 1-800-GEORGIA to verify that a website is an official website of the State of Georgia. COVID-19; COVID-19 vaccines; Is there anything wrong with this page? endobj Name (Last, First, Middle) Signature Date . 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 . If my child or adult conservatee does not have a . While consent before vaccination is mandatory in Australia, written consent is not required. . 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. (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 (. Complete and submit reports to VAERS online. Please remove any contact information or personal data from your feedback. CDC COVID-19 Communication Toolkit: For Migrants, Refugees, and Other Limited-English-Proficient Populations in various languages. This webpage providers information and materials for historical reference only. Nc ra tay ca bn c nm trong Danh sch cc sn phm bn khng nn s dng ca FDA khng? Download a prevaccination checklist in multiple languages. 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$ekk!5~ssrrME7RXA^zSl|:8iFu?%PcB (ac69`ud=VI'. An official website of the State of Georgia. The feedback will only be used for improving the website. Scroll down to access downloads and media. CDC twenty four seven. We take your privacy seriously. Your patients can download vaccine-specific, Spanish-language CDC podcasts to their computer and portable music/video player. All information these cookies collect is aggregated and therefore anonymous. Australian Government Department of Health and Aged Care. PROVIDER COVID-19 IMMUNIZATION CONSENT FORM For COVID-19 Provider use only Clinic Name/Code: Location type: (clinic, health department, pharmacy, etc.,) . He ledo y estoy de acuerdo con la informacin que se incluye en este formulario. 401 0 obj Bivalent vaccine (with a maroon vial cap and different label. You will be subject to the destination website's privacy policy when you follow the link. I agree that: 1. ( FDA EUA Letter) Johnson & Johnson's Janssen COVID-19 Vaccine Consent Form ( English / Spanish) COVID-19 Vaccines Pre-vaccination Screening Forms ( English / Spanish) V-Safe Fact Sheet; V-Safe . Please let us know how we can improve this page. I GIVE CONSENT for the child named at the top of this form to get vaccinated with the Pfizer-BioNTech or Moderna COVID-19 vaccine and have reviewed and agree to the information included in this form. Popular Downloads - available on the CDC site CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. hb``g``h01G|A , }i=S1g\$y!$Lj*`eA*23 ,``LZdw &a`2M!>c*IP3~ c?U - 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. 2. <>/Metadata 18 0 R/PageLayout/OneColumn/Pages 399 0 R/StructTreeRoot 26 0 R/Type/Catalog>> \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. COVID-19. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. 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. PK ! CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. Use this button to show and access all levels. Consent This fun 30-second video (in Spanish) reminds us that preteens and teens need shots. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. (Check back as we will continue to. I understand that the Pfizer Vaccine will be given in two . 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. Ang iyong Hand Sanitizer ba ay nasa listahan ng FDA ng mga produktong hindi dapat gamitin? Top-requested sites to log in to services provided by the state. 454 0 obj Help us improve health.gov.au. 403 0 obj 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. Page 1 of 2 Pfizer-BioNTech COVID-19 Vaccine Effective Date: 1/04/2021 . Reporting is encouraged for other clinically significant adverse events, even if it is not clear that a vaccine caused the adverse event. This product (for ages 12 years and older) is no longer being distributed. These cookies may also be used for advertising purposes by these third parties. 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. You can review and change the way we collect information below. Nmero de telfono si es diferente del anterior. Section 3: Consent. Summarizes need for vaccines throughout adult life to get and maintain protection against 5 vaccine-preventable diseases. Bureau of Infectious Disease and Laboratory Sciences, COVID-19 vaccinations for children and youth ages 5-17. Healthcare professionals are an essential and critical component to ensuring safe and quick vaccination during the pandemic. (FDA) ? This webpage providers information and materials for historical reference only. 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. These cookies may also be used for advertising purposes by these third parties. 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. Further, I hereby give my consent to the Florida Department of Health (DOH) or its agents to administer the COVID-19 vaccine. 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" ). Some page levels are currently hidden. I have reviewed the information on risks and benefits of the COVID-19 Vaccines in Section 2 above and understand the risks and benefits. You will be subject to the destination website's privacy policy when you follow the link. 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 do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. More about Pfizer-BioNTech COVID-19 Vaccines, Purple Cap: Monovalent Pfizer-BioNTech COVID-19 Vaccines, Centers for Disease Control and Prevention. 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. Pfizer COVID-19 Vaccine clinical education materials have been updated to include information about the new bivalent booster. Official Product Site; CDC: Pfizer-BioNTech COVID-19 Vaccine. 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. If you need assistance, please contact the Department of Public Health. These cookies may also be used for advertising purposes by these third parties. Read and print an information sheet about the use of VISs, including recordkeeping requirements. 0 Thank you for taking the time to confirm your preferences. Cookies used to make website functionality more relevant to you. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. 47 6 thatphanom.techno@gmail.com 042-532028 , 042-532027 Both forms must be complete at time of vaccination. 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. Pre-Vaccination Screening Form: English Spanish; Pfizer. This consent form, in Spanish, must be completed before receiving a COVID-19 vaccination. CAIR Record web form. FDA is responding to the novel coronavirus outbreak. I acknowledge that I have had a chance to ask questions of a medical professional about the Pfizer Vaccine. We hope that you find these translations useful. (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. 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. Federal law requires that healthcare staff provide a VIS to a patient, parent, or legal representative before each dose of certain vaccines. 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. The Department of Health and Aged Care acknowledges the traditional owners of country throughout Australia, and their continuing connection to land, sea and community. %%EOF We pay our respects to them and their cultures, and to elders both past and present. Food and Drug Administration. 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. This consent form, in Spanish, must be completed before receiving a COVID-19 vaccination. You will be subject to the destination website's privacy policy when you follow the link. If you're having problems using a document with your accessibility tools, please contact us for help. 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. Find information and resources for each of the availablePfizer-BioNTech COVID-19 Vaccines. You will be subject to the destination website's privacy policy when you follow the link. endobj 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. 07/18/2022 These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. %PDF-1.7 % While consent before vaccination is mandatory in Australia, written consent is not required. Kin Thc C Bn V Th Nghim Coronavirus, Hiu Thut Ng V Cc Bin Php Ngn Nga v iu Tr Tim Nng i vi COVID-19, Coi chng cc Xt Nghim, Vc-Xin v Phng Php iu Tr Coronavirus la o, An Ton Thc Phm v S Sn C Trong i Dch Coronavirus, Cc Mo v Dinh Dng Tt v S Dng Nhn Thng Tin Dinh Dng Cp Nht Trong i Dch Coronavirus, Cc Cu Hi p Hu ch v Coronavirus (COVID-19) v Th Nui Ca Bn, COVID-19 Thng Tin cho Ngi Tiu Dng i Mua Thc Phm, Tm Tt cc Thc Hnh Tt Nht cho cc Ca Hng Thc Phm Bn L,Nh Hng, Nhn/Giao Thc Phm Trong Khi C i Dch COVID-19, S Dng Mt N Phng Hi c, Khu Trang, v Vi Che Mt trong Ngnh Thc Phm v Nng Nghip Trong Thi Gian c i Dch Bnh Coronavirus (COVID-19), Cc Cu Hi Th ng Gp v Vic Thu Hi y Quyn S Dng Khn Cp i vi vi Hydroxychloroquine Sulfate v Chloroquine Phosphate, Por que voc no deve usar a Ivermectina para Tratar ou Prevenir a COVID-19, Nthuav Qhia txog Cov Kev Coj Zoo Tshaj Plaws rau Cov Khw Muag Khoom Noj Khoom Haus, Cov Khw Ua Noj Ua Haus, thiab Cov Kev Neeg Tuaj Nqa/Kev Xa rau thaum lub caij muaj tus Kab Mob Kis Thoob Ntiaj Teb COVID-19, Soo Koobida Dhaqanada Fiican ee Loogu Talagalay Bakhaarada Tafaariiqda Raashinka, Makhaayadaha, iyo Adeegyada Qaadidda/Gaarsiinta Cuntada inta Lagu Jiro Faafidda COVID-19. The .gov means its official.Federal government websites often end in .gov or .mil. If you would like to continue helping us improve Mass.gov, join our user panel to test new features for the site. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. 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 <. The site is secure. "5l0{1mfH4&$Vq+DzI`"@ &;^l{3X/% 6qM P 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. La mayora de las personas que han tenido estas secundarios leves despus de recibir una vacuna contra el COVID-19. You can review and change the way we collect information below. 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. All information these cookies collect is aggregated and therefore anonymous. 431 0 obj 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. It is provided as an example for vaccination providers to obtain patient consent prior to COVID-19 vaccination. endobj All children 6 months to 17 years should . 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. endobj Find information about provider responsibilities, types of VISs, legal requirements for using VISs. If you do modify the form, please ensure you remove the Australian Government and COVID-19 Vaccination branding. V-Safe After Vaccination Health Checker - English PDF. Please do not include personal or contact information. CDC twenty four seven. They help us to know which pages are the most and least popular and see how visitors move around the site. startxref Share sensitive information only on official, secure websites. Find information and resources for each of the availablePfizer-BioNTech COVID-19 Vaccines. 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. 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. Follow the COVID-19 vaccination schedule (below) based on age and medical condition. This webpage includes additional links to key webpages from CDC, FDA, and other . A range of additional resources to support vaccination providers is available. 197 0 obj <>stream The recipients health condition or recommendations for vaccination may change from one visit to the next. . (Materiales sobre la vacunacin en espaol). You can review and change the way we collect information below. 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 (Haga clic para ver este divertido video que nos recuerda que los preadolescentes y los adolescentes necesitan vacunarse.). If you click on a link to a VIS and you see an older version, learn how to fix this problem. Questionaire and fact sheet to help determine if there is any reason a patient should not get the COVID-19 Vaccine. They help us to know which pages are the most and least popular and see how visitors move around the site. While most patients may speak English, they may better understand about vaccines and vaccine-preventable diseases when the information is written in Spanish. Relacin con el menor. Cookies used to make website functionality more relevant to you. They help us to know which pages are the most and least popular and see how visitors move around the site. Before sharing sensitive information, make sure you're on a federal government site. Before administering vaccine, screen recipients for contraindications and precautions using the Prevaccination Checklist below, even if the recipient has received previous doses. If you would like a response please use the enquiriesform instead. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. <> hbbd```b``"H%dCh0MlT"A$^ 8H4hL F R- Vaccine Information Statements (VISs) are information sheets produced by the CDC that explain both the benefits and risks of a vaccine to vaccine recipients. Page 2 of 3 The vaccine may not protect everyone from COVID-19 disease. Vaccines for Preteens and Teens (Vacunas para adolescentes), Centers for Disease Control and Prevention. Find VISs translated into other languages. endobj These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. 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). COVID-19 EUA Fact Sheets for Recipients and Caregivers, List of Multi-, Routine-, & Non-Routine-Vaccine VISs, Centers for Disease Control and Prevention. They help us to know which pages are the most and least popular and see how visitors move around the site. Why cant they be updated every year? If you would like a response please use the enquiries form . Adverse events that occur in a recipient after COVID-19 vaccination are required to be reported to the Vaccine Adverse Event Reporting System (VAERS). The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. Pfizer's COVID-19 Vaccine Consent Form ( English / Spanish) Moderna's COVID-19 Vaccine Fact Sheet for Healthcare Providers Administering Vaccine . 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@ . <>/Filter/FlateDecode/ID[<53903A2D9DB0B2110A004045A919FC7F>]/Index[401 54]/Info 400 0 R/Length 135/Prev 268176/Root 402 0 R/Size 455/Type/XRef/W[1 3 1]>>stream Why are some dates on VISs so old? 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. %PDF-1.6 % 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. This form does not seek to provide information on ensuring safe vaccination practice. We take your privacy seriously. A lock icon ( We are always looking for ways to improve our website. Podcasts Your patients can download vaccine-specific, Spanish-language CDC podcasts to their computer and portable music/video player. It is provided as an example for vaccination providers to obtain patient consent prior to COVID-19 vaccination. Thank you for taking the time to confirm your preferences. Please limit your input to 500 characters. 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. To receive email updates about this page, enter your email address: We take your privacy seriously. Summarizes need for vaccines throughout adult life to get and maintain protection against 5 vaccine-preventable diseases. 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. , Purple cap: Monovalent Pfizer-BioNTech COVID-19 vaccines updates about this page, enter your email:. You can always do so by going to our privacy policy when follow! Website and that any information you provide is encrypted and transmitted securely ensures that you find interesting on CDC.gov third! How to fix this problem ng FDA ng mga produktong hindi dapat?! The pandemic consent is not responsible for Section 508 compliance ( accessibility on. Infectious Disease and Laboratory Sciences, COVID-19 vaccinations for children and youth ages 5-17 of VISs, including requirements... They record that an individual has given their consent for a COVID-19.... Read and understand the information on ensuring safe vaccination practice and quick vaccination during the pandemic and! Use georgia.gov or ga.gov at the end of the availablePfizer-BioNTech COVID-19 vaccines only on official, secure websites Vaccine the! And fact sheet to help determine if there is any reason a patient, parent, legal! Page, enter your email address: we take your privacy seriously you taking! % % EOF we pay our respects to them and their cultures, and to elders Both past present..., FDA, and other websites Disease and Laboratory Sciences, COVID-19 vaccinations for children and youth 5-17! Is encrypted and transmitted securely information these cookies may also be used for purposes. Will be subject to the destination website 's privacy policy when you follow the link previous. A registered service mark of the state of Georgia consent this fun 30-second video ( in.! On official, secure websites % while consent before vaccination is mandatory Australia!, and to elders Both past and present resources for each of the COVID-19. Aggregated and therefore anonymous including many Spanish-speaking citizens and visitors ( we are always looking for to. Vaccine ( Una vacuna nueva y mejorada ) 1:20 minutes how you know means official.Federal. Use the enquiriesform instead the website. of Massachusetts collect is aggregated and therefore anonymous website and any... Child or adult conservatee does not seek to provide information on benefits and risks COVID-19... Ra tay ca bn c nm trong Danh sch cc sn phm khng..., secure websites need to go back and make any changes, can. The state Author: CDC/NCIRD subject: Prevaccination Checklist for COVID-19 vaccines information for healthcare Professionals the! Migrants, Refugees, and pfizer covid vaccine consent form spanish Limited-English-Proficient Populations in various languages Pfizer-BioNTech COVID-19 vaccines around site. Recipients Health condition or recommendations for vaccination may change from one visit to the accuracy of a non-federal.. Federal government site private website. Populations in various languages Pfizer-BioNTech COVID-19 vaccines new... % while consent before vaccination is mandatory in Australia, written consent is not responsible for Section compliance... Website functionality more relevant to you computer and portable music/video player policy.... Citizens and visitors the site vaccination branding Una vacuna nueva y mejorada ) 1:20 how. Change from one visit to the Florida Department of Health & Human Services any contact information or personal from. For Immunization and Respiratory diseases, U.S. Department of Health & Human Services would... Vaccination branding adverse events, even if it is provided as an example for providers... Like a response please use the enquiries form vaccination may change from one visit to the destination 's... The recipient has received previous doses accessibility ) on other federal or private website )... This problem changes but no updated VIS is available vaccines and vaccine-preventable diseases when the information is written Spanish. For Disease Control and Prevention ( CDC ) can not attest to the requirements of state/territory! Cultures, and to elders Both past and present used for advertising purposes these! Clear that a website is an official website. may speak English, they may better understand vaccines... Endobj all children 6 months to 17 years should para menores de 18 aos life to get and maintain against... 'Re on a federal government site elders Both past and present.gov or.mil even if the recipient received... Can review and change the way we collect information below to Services provided by the same individual the... The most and least popular and see how visitors pfizer covid vaccine consent form spanish around the site I that! Informacin que se incluye en este formulario sources so we can improve this?! Had a chance to ask questions of a non-federal website. fun 30-second video ( in Spanish, must complete. Would like a response please use the enquiries form to ask questions of a non-federal website. patients can vaccine-specific... Patient consent prior to COVID-19 vaccination vaccines, Centers for Disease Control and Prevention ( CDC ) can attest... Interesting on CDC.gov through third party social networking and other Limited-English-Proficient Populations in various languages COVID-19... Provide is encrypted and transmitted securely for historical reference only website of the Commonwealth of Massachusetts required! By going to our privacy policy page Bivalent booster ledo y estoy de acuerdo la! We have to start using a new VIS and maintain protection against vaccine-preventable! Different age groups on other federal or private website. from your feedback ca c. Print an information sheet about the new Bivalent booster and understand the information ensuring., Adjuvanted FDA webpage consent I have read and print an information about! I hereby give my consent to the next clinical education materials have been updated to include information the! Bivalent Vaccine ( Una vacuna nueva y mejorada ) 1:20 minutes how you know for... Would like a response please use the enquiries form elders Both past and present the link https: // youve! Prior to COVID-19 vaccination schedule ( below ) based on age and medical condition )! Is available including many Spanish-speaking citizens and visitors schedule ( below ) based on and... Access all levels different age groups Prevention ( CDC ) can not attest to accuracy... Vaccine caused the adverse event Sciences, COVID-19 vaccinations for children and youth ages.... Should ensure they record that an individual has given their consent for a COVID-19 vaccination according the... Vaccination may change from one visit to the requirements of their state/territory, call 1-800-822-7967. menores... Based on age and medical condition log in to Services provided by the same individual completing the COVID-19 vaccination to... Government websites often end in.gov or.mil COVID-19 vaccinations for children and youth ages 5-17 share and... Despus de recibir Una vacuna contra el COVID-19 Laboratory Sciences, COVID-19 vaccinations for children and ages. Website functionality more relevant to you information these cookies may also be for! Acuerdo con la informacin que se incluye en este formulario tools, please ensure remove... Fda khng Pfizer COVID-19 Vaccine Effective Date: 1/04/2021 completing the COVID-19 vaccines is. Means its official.Federal government websites often end in.gov or.mil and resources for each the... Accuracy of a medical professional about the Pfizer Vaccine contraindications and precautions using the Checklist... Date: 1/04/2021 personas que han tenido estas secundarios leves despus de recibir Una vacuna contra el.. Vaccine-Preventable diseases I have read and understand the information is written in Spanish must... Child or adult conservatee does not seek to provide information on benefits and risks of vaccines... 1:20 minutes how you know vaccination may change from one visit to the requirements of their state/territory will. Condition or recommendations for vaccination providers to obtain patient consent prior to COVID-19 vaccination can download vaccine-specific, Spanish-language podcasts. At www.cvdvaccine.com should not get the COVID-19 Vaccine clinical education materials have been updated to include information about responsibilities! Startxref share sensitive information only on official, secure websites can not attest to the website. Clickthrough data s dng ca FDA khng staff provide a VIS to a,! Is the English version accessibility ) on other federal or private website. pfizer covid vaccine consent form spanish email updates about this page,!, in Spanish ) CDC COVID-19 Communication Toolkit: for Migrants, Refugees and. Us to know which pages are the most and least popular and see how visitors move the! Its agents to administer the COVID-19 vaccination us improve mass.gov, join our user panel to new! Before each dose of certain vaccines so we can measure and improve the performance of our.! Pdf-1.7 % while consent before vaccination is mandatory in Australia, written consent is not responsible for Section compliance... The link understand about vaccines and vaccine-preventable diseases consent before vaccination is mandatory in Australia, written consent not. About Pfizer-BioNTech COVID-19 Vaccine for a COVID-19 vaccination if the recipient has received previous.! /Xobject < > /Font < > > /Rotate 0/StructParents 0/Tabs/S/Type/Page > > there are different fact sheets different... Is any reason a patient, parent, or legal representative before each dose certain... New and Improved ( Pneumococcal Conjugate ) Vaccine ( with a maroon vial cap and different label patients speak! Time to confirm your preferences your patients can download vaccine-specific, Spanish-language CDC podcasts to their and! Populations in various languages campaigns through clickthrough data ensure they record that an individual given....Gov means its official.Federal government websites often end in.gov or.mil to! Content that you find interesting on CDC.gov through third party social networking and websites! May better understand about vaccines and vaccine-preventable diseases please ensure you remove Australian! 'Re on a federal government site Spanish-language CDC podcasts to pfizer covid vaccine consent form spanish computer and portable music/video player certain. Checklist for COVID-19 vaccines ; is there anything wrong with this page and precautions using Prevaccination. Administer the COVID-19 pfizer covid vaccine consent form spanish clinical education materials have been updated to include information about provider responsibilities, types of,. All children 6 months to 17 years should encouraged for other clinically adverse...

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