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PLEASE PRINT CLEARLY Today's Date/ / 2021 ? 1st Dose Moderna ? 2nd Dose Moderna? 1st Dose Pfizer ? 2nd Dose Pfizer? 1 Dose J&JJanssenFirst Dose Date/ / 2021Last Name First Name Middle Initial Date
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To fill out 'I got AstraZeneca for', follow these steps:
02
Write your name and contact information at the top of the form.
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Check the box next to 'AstraZeneca' under the vaccine section.
04
Fill in the date and location where you received the AstraZeneca vaccine.
05
Provide any additional information required, such as the healthcare professional who administered the vaccine.
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Review the form for accuracy and completeness.
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Sign and date the form at the bottom.
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Submit the filled-out form to the appropriate authority or organization as instructed.

Who needs i got astrazeneca for?

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Those who require 'I got AstraZeneca for' include individuals who received the AstraZeneca vaccine.
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This form may be needed for various purposes, such as documenting vaccine administration, tracking immunizations, or providing proof of vaccination.

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I Got AstraZeneca refers to receiving the AstraZeneca COVID-19 vaccine, which is intended to provide immunity against the coronavirus.
Individuals who have received the AstraZeneca vaccine and are required to document their vaccination status for travel, employment, or health purposes may need to file information related to it.
To fill out the documentation for receiving the AstraZeneca vaccine, individuals should provide personal information, vaccination details such as date, batch number, and the healthcare provider's information.
The purpose of documenting the AstraZeneca vaccination is to confirm immunization status and to comply with health regulations, travel requirements, or employer mandates.
The information that must be reported includes the individual's name, date of vaccination, vaccine batch number, and the administering healthcare provider's information.
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