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Get the free PDF Pfizer-BioNTech COVID-19, CHI St Vincent Consent Form.pdf

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Version date: 2/1/2021 (v3)Pfizer BioNTech COVID-19 Vaccine Consent Form CHI St. Vincent Section 1: Personal Information (please print or affix patient sticker) NAME (Last)(First)(M.I.) Affix patient
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The PDF Pfizer-BioNTech COVID-19 CHI form may be needed by individuals who:
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- Are scheduled for a Pfizer-BioNTech COVID-19 vaccination.
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- Wish to receive a vaccination certificate or record.
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Pdf pfizer-biontech covid-19 chi is a form used to report covid-19 vaccine data from Pfizer-BioNTech.
Healthcare providers and organizations administering the Pfizer-BioNTech covid-19 vaccine are required to file the form.
The form can be filled out electronically or manually with information such as doses administered, adverse reactions, and patient demographics.
The purpose of the form is to collect and report data on the administration of the Pfizer-BioNTech covid-19 vaccine for monitoring and evaluation purposes.
Information such as number of doses administered, patient demographics, adverse reactions, and vaccination site details must be reported on the form.
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