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COVID-19 VACCINE SCREENING AND CONSENT FORM Moderna COVID-19 Vaccine Bookshop Pharmacy 3506 E. Lincoln Hwy, Thorn dale, PA 19372 Phone: (610) 3846100 Name: First: Last: Middle initial: DOB: / / Address:

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How to fill out covid-19 vaccine screening and

01

Step 1: Visit the official website of the healthcare organization or government agency responsible for administering COVID-19 vaccines.

02

Step 2: Look for the online screening form or questionnaire.

03

Step 3: Fill out the required personal information, such as name, age, and contact details.

04

Step 4: Answer the screening questions regarding your medical history, symptoms, and exposure to COVID-19.

05

Step 5: Submit the completed form online.

06

Step 6: Wait for further instructions from the healthcare organization or government agency regarding your eligibility and appointment for the COVID-19 vaccine.

Who needs covid-19 vaccine screening and?

01

Individuals who are eligible for COVID-19 vaccine based on the guidelines provided by the healthcare organization or government agency.

02

People who are at higher risk of severe illness or complications from COVID-19, such as older adults, individuals with certain medical conditions, and healthcare workers.

03

Anyone who wants to protect themselves and contribute to the collective effort to control the spread of COVID-19.

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What is covid-19 vaccine screening and?

Covid-19 vaccine screening is the process of reviewing an individual's medical history to determine if they are eligible to receive a covid-19 vaccination.

Who is required to file covid-19 vaccine screening and?

Individuals who are seeking to receive a covid-19 vaccine are required to undergo the screening process.

How to fill out covid-19 vaccine screening and?

To fill out covid-19 vaccine screening, individuals must provide information about their medical history, current health status, and any known allergies or underlying conditions.

What is the purpose of covid-19 vaccine screening and?

The purpose of covid-19 vaccine screening is to ensure that individuals are safe to receive a covid-19 vaccination and to prevent any potential adverse reactions.

What information must be reported on covid-19 vaccine screening and?

Information such as medical history, current health status, allergies, and underlying conditions must be reported on covid-19 vaccine screening.

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