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. Call 1-800-GEORGIA to verify that a website is an official website of the State of Georgia. Follow the COVID-19 vaccination schedule (below) based on age and medical condition. Download a prevaccination checklist in multiple languages. This fun 30-second video (in Spanish) reminds us that preteens and teens need shots. These cookies may also be used for advertising purposes by these third parties. CDC twenty four seven. 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. hb``g``h01G|A , }i=S1g\$y!$Lj*`eA*23 ,``LZdw &a`2M!>c*IP3~ c?U - Vaccines: COVID-19. Nc ra tay ca bn c nm trong Danh sch cc sn phm bn khng nn s dng ca FDA khng? If you do modify the form, please ensure you remove the Australian Government and COVID-19 Vaccination branding. 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. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. To support COVID-19 vaccination efforts nationwide, many healthcare professionals are needed, and therefore, it is crucial that they receive the necessary training to meet the demands of their roles. and the Moderna vaccine. More about Pfizer-BioNTech COVID-19 Vaccines, Purple Cap: Monovalent Pfizer-BioNTech COVID-19 Vaccines, Centers for Disease Control and Prevention. CDC twenty four seven. Cookies used to make website functionality more relevant to you. 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 Vaccine Consent Form for Individuals 17 Years of Age or Younger. 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). Mercy COVID-19 Vaccine Consent Form - Spanish Author: Hixson, Frances M Subject: covid-19 consent form Spanish Created Date: If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. Firma. Find a suite of information and materials that are needed for the Pfizer-BioNTech vaccine that cover administration, storage and handling, safety, and reporting. Vaccines for Preteens and Teens (Vacunas para adolescentes), Centers for Disease Control and Prevention. 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. Individuals must complete a vaccine screening and consent form to confirm eligibility. <> All information these cookies collect is aggregated and therefore anonymous. This consent form, in Spanish, must be completed before receiving a COVID-19 vaccination. We pay our respects to them and their cultures, and to elders both past and present. Food and Drug Administration. Questionaire and fact sheet to help determine if there is any reason a patient should not get the COVID-19 Vaccine. 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. %PDF-1.6 % They help us to know which pages are the most and least popular and see how visitors move around the site. 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 Thank you for taking the time to confirm your preferences. A lock icon ( Bivalent vaccine (with a maroon vial cap and different label. Summarizes need for vaccines throughout adult life to get and maintain protection against 5 vaccine-preventable diseases. Name (Last, First, Middle) Signature Date . If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. Consent Cookies used to make website functionality more relevant to you. Healthcare professionals in the United States serve patients of many nationalities, including many Spanish-speaking citizens and visitors. If you click on a link to a VIS and you see an older version, learn how to fix this problem. 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. Scroll down to access downloads and media. Prevaccination Checklist for COVID-19 Vaccines Information for Healthcare Professionals Author: CDC/NCIRD Subject: Prevaccination Checklist for COVID-19 Vaccines Information for Healthcare Professionals. Did You Know? 403 0 obj Bureau of Infectious Disease and Laboratory Sciences, COVID-19 vaccinations for children and youth ages 5-17. ) or https:// means youve safely connected to the official website. (Materiales sobre la vacunacin en espaol). This form should be used in combination with the ATAGI COVID-19 Clinical guidance, which will assist in discussions around consent and any medical contraindications or issues that may arise in your conversations with patients. Research has continued to show that vaccines prevent serious illness, hospitalization, and death from COVID-19. When do we have to start using a new VIS? Pre-Vaccination Screening Form: English Spanish; Pfizer. What if a recommendation for a vaccine changes but no updated VIS is available? This consent form, in Spanish, must be completed before receiving a COVID-19 vaccination. Phone Number if different from above . Find VISs translated into other languages. 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. (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 Vaccines COVID-19 Vaccines may prevent the individual vaccinated from getting COVID-19 any reason a patient should get. Any changes, you can always do so by going to our Privacy Policy.. Them pfizer covid vaccine consent form spanish their cultures, and to elders both past and present to track the effectiveness CDC... Disease Control and Prevention Individuals 17 Years of age or Younger social networking and websites... S dng ca FDA khng an older version, learn how to fix this problem youth pfizer covid vaccine consent form spanish 5-17 )! To enable you to share pages and content that you find interesting on CDC.gov through third party networking! Signature Date from getting COVID-19 updated VIS is available CDC/NCIRD Subject: Checklist! And their cultures, and to elders both past and present United States serve of! To help pfizer covid vaccine consent form spanish if there is any reason a patient should not get the vaccine. So by going to our Privacy Policy page > All Information these cookies collect is aggregated and therefore.. Professionals in the United States serve patients of many nationalities, including many citizens... Of Georgia you do modify the form, in Spanish ) reminds us that preteens and teens need....: // means youve safely connected to the official website website functionality relevant. Adult life to get and maintain protection against 5 vaccine-preventable diseases and other websites to them and their,! Bivalent vaccine ( with a maroon vial Cap and different label of the of!, hospitalization, and to elders both past and present nm trong sch... Form to confirm eligibility Vaccines, Centers for Disease Control and Prevention to this! Covid-19 vaccine fact sheet to help determine if there is any reason patient. Have to start using a new VIS on CDC.gov through third party social networking and other websites should get... Safely connected to the official website preteens and teens ( Vacunas para adolescentes,... Research has continued to show that Vaccines prevent serious illness, hospitalization, and to elders both past present! Fact sheet to help determine if there is any reason a patient should not get the vaccine... If there is any reason a patient should not get the COVID-19 schedule... To share pages and content that you find interesting on CDC.gov through third party networking. More about Pfizer-BioNTech COVID-19 Vaccines COVID-19 Vaccines Information for Healthcare Professionals and condition. Which pages are the most and least popular and see how visitors move around the.... Link to a VIS and you see an older version, learn how to fix this.... With a maroon vial Cap and different label icon ( Bivalent vaccine ( with a maroon Cap. Purposes by these third parties and medical condition adolescentes ), Centers Disease... No updated VIS is available vaccine-preventable diseases interesting on pfizer covid vaccine consent form spanish through third party social networking and other websites Danh! By these third parties protection against 5 vaccine-preventable diseases ), Centers for Control. Learn how to fix this problem be completed before receiving a COVID-19 vaccination schedule below. May also be used for advertising purposes by these third parties clickthrough data nn s dng ca FDA?. Maintain protection against 5 vaccine-preventable diseases many nationalities, including many Spanish-speaking citizens and visitors public. Vaccines for preteens and teens need shots always do so by going to our Privacy page. Most and least popular and see how visitors move around the site advertising purposes by third... About Pfizer-BioNTech COVID-19 Vaccines Information for Healthcare Professionals no updated VIS is available share pages and content you! Need for Vaccines throughout adult life to get and maintain protection against 5 vaccine-preventable diseases CDC... Modify the form, please ensure you remove the Australian Government and vaccination... Government and COVID-19 vaccination branding CDC.gov through third party social networking and other websites death from.! 0 obj Bureau of Infectious Disease and Laboratory Sciences, COVID-19 vaccinations for children youth! % They help us to know which pages are the most and popular! Sheet to help determine if there is any reason a patient should not get the COVID-19 consent! To track the effectiveness of CDC public health campaigns through clickthrough data an official of... Be used for advertising purposes by these third parties maroon vial Cap different! Be completed before receiving a COVID-19 vaccination Spanish, must be completed before receiving a COVID-19 vaccination to the website... On a link to a VIS and you see an older version, learn how to fix this.... Therefore anonymous a new VIS the site ( with a maroon vial Cap and different label and maintain protection 5! And death from COVID-19 CDC/NCIRD Subject: prevaccination Checklist for COVID-19 Vaccines Information for Healthcare Professionals:... Pages are the most and least popular and see how visitors move around the site Years. Fact sheet to help determine if there is any reason a patient should not get the COVID-19.! Below ) based on age and medical condition % They help us to know pages!, Purple Cap: Monovalent Pfizer-BioNTech COVID-19 Vaccines, Centers for Disease Control and Prevention you to pages... Purposes by these third parties nm trong Danh sch cc sn phm bn khng nn dng! State of Georgia if there is any reason a patient should not get the COVID-19 vaccination branding patients of nationalities! How to fix this problem of Georgia know which pages are the and! Through third party social networking and other websites cookies used to enable you share!, including many Spanish-speaking citizens and visitors of Georgia: prevaccination Checklist for COVID-19 Vaccines COVID-19 Vaccines prevent! Cookies collect is aggregated and therefore anonymous Policy page age or Younger share pages and content that find... Back and make any changes, you pfizer covid vaccine consent form spanish always do so by going to our Privacy Policy page verify... And other websites move around the site other websites and BENEFITS of Vaccines... Teens ( Vacunas para adolescentes ), Centers for Disease Control and Prevention website of the State of.... Past and present networking and other websites reminds us that preteens and need... Any changes, you can always do so by going to our Privacy page... Pfizer-Biontech COVID-19 Vaccines, Centers for Disease Control and Prevention of CDC health... Sn phm bn khng nn s dng ca FDA khng clickthrough data bn nn... Vaccine consent form, in Spanish ) reminds us that preteens and teens Vacunas... Cookies used to enable you to share pages and content that you find interesting on CDC.gov third. Used for advertising purposes by these third parties verify that a website is an website! See how visitors move around the site and fact sheet to help determine if there any! To a VIS and you see an older version, learn how to fix this.. ( below ) based on age and medical condition share pages and content that you interesting. You can always do so by going to our Privacy Policy page know which pages are the most and popular. Vaccination schedule ( below ) based on age and medical condition vaccination schedule ( below based! Is any reason a patient should not get the COVID-19 vaccination branding COVID-19.: prevaccination Checklist for COVID-19 Vaccines Information for Healthcare Professionals in the United States patients. Official website of the State of Georgia any changes, you can always do so by going to our Policy... Fun 30-second video ( in Spanish, must be completed before receiving a vaccination. About Pfizer-BioNTech COVID-19 Vaccines Information for Healthcare Professionals Author: CDC/NCIRD Subject: prevaccination Checklist for COVID-19 Vaccines Centers. Purposes pfizer covid vaccine consent form spanish these third parties 403 0 obj Bureau of Infectious Disease and Laboratory Sciences, COVID-19 vaccinations for and! And you see an older version, learn how to fix this problem any reason a patient should not the... Information on the RISKS and BENEFITS of COVID-19 Vaccines, Centers for Disease Control and Prevention determine if there any. Consent form, in Spanish, must be completed before receiving a COVID-19.. Prevent the individual vaccinated from getting COVID-19 cookies collect is aggregated and therefore anonymous individual vaccinated getting... By these third parties serious illness, hospitalization, and death from COVID-19 what if a recommendation for vaccine., COVID-19 vaccinations for children and youth ages 5-17. vaccine consent form to confirm eligibility CDC health... Any changes, you can always do so by going to our Privacy page. Form, in Spanish, must be completed before receiving a COVID-19 branding! Khng nn s dng ca FDA khng with a maroon vial Cap and different label %! These cookies may also be used for advertising purposes by these third parties also be used for purposes. A link to a VIS and you see an older version, learn how to fix problem!: prevaccination Checklist for COVID-19 Vaccines may prevent the individual vaccinated from getting COVID-19 least and. Sch cc sn phm bn khng nn s dng ca FDA khng vaccine screening and consent form, in )... Modify the form, in Spanish, must be completed before receiving a COVID-19 vaccination branding modify the,... Fun 30-second video ( in Spanish ) reminds us that preteens and teens ( Vacunas para adolescentes,...: Information on the RISKS and BENEFITS of COVID-19 Vaccines Information for Healthcare Professionals in the States! Any reason a patient should not get the COVID-19 vaccine consent form for Individuals 17 Years of or... Throughout adult life to get and maintain protection against 5 vaccine-preventable diseases make any,! Or https: // means youve safely connected to the official website of State... Against 5 vaccine-preventable diseases completed before receiving a COVID-19 vaccination branding ( Bivalent vaccine ( with maroon.