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VACCINE CONSENT FORM CHECK THE VACCINES YOUR CHILD SHOULD RECEIVE Trap Meningitis(1st shot at 11 Yrs and booster at 16 Yrs) Influenza (shot) HPV Medicaid Eligible Only Forward Health ID# Student Name
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How to fill out vaccine information statementcurrent visscdc

01
Read the vaccine information statement (VIS) carefully before filling it out.
02
Provide the patient's name, date of birth, and address.
03
Ensure that the vaccine name, lot number, and expiration date are accurate.
04
Record the date the vaccine was administered and the administering healthcare professional's information.
05
Clearly indicate any adverse reactions or side effects experienced by the patient.
06
Sign and date the VIS to authenticate the information provided.

Who needs vaccine information statementcurrent visscdc?

01
Anyone who is receiving a vaccine should be provided with a vaccine information statement (VIS).
02
This includes individuals of all ages, including infants, children, adolescents, and adults.
03
Healthcare providers should ensure that patients and their caregivers understand the information provided in the VIS.
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Vaccine Information Statement (VIS) is a document produced by the Centers for Disease Control and Prevention (CDC) that provides essential information about the benefits and risks of a vaccine.
Healthcare providers are required to give the Vaccine Information Statement (VIS) to patients before administering a vaccine.
To fill out the Vaccine Information Statement (VIS), healthcare providers need to provide information such as the patient's name, date of birth, the vaccine being administered, and the date of administration.
The purpose of the Vaccine Information Statement (VIS) is to ensure that patients are informed about the benefits and risks of a vaccine before receiving it.
The Vaccine Information Statement (VIS) must include information on the vaccine being administered, the risks and benefits, and where to find more information.
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