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Pfizer BioNTech COVID-19 Vaccination Consent under Emergency Use Authorization (EUA) Patient Demographic Information Last Name: Date of Birth:First Name: /Gender: Male Female Transgendered/Race: White
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The leonfloridahealthgovpfizer-screen-consent-formcovid-19 vaccine screening is a consent form that individuals must complete to assess their eligibility and consent to receive the Pfizer COVID-19 vaccine.
Individuals who wish to receive the Pfizer COVID-19 vaccine are required to file the screening form.
To fill out the form, individuals typically need to provide their personal information, health history, and any allergies they may have, and then sign to indicate their consent.
The purpose of the screening form is to ensure that individuals are informed about the vaccine, assess their health status for eligibility, and document their consent to receive the vaccine.
The information that must be reported includes personal identification details, medical history, exposure to COVID-19, and any potential allergies.
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