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COLLINS PHARMACY, INC. COVID-19 VACCINATION CONSENT Section 1: Vaccine Recipient Information (Required) Last Name:First Name:MI:DOB:Street Address:Gender:City:State:Zip:Phone Number: Ethnicity: Race:Age:County
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Covid-19 multi dose consent2docx is a form that allows individuals to provide consent for receiving multiple doses of the Covid-19 vaccine.
Any individual who wants to receive multiple doses of the Covid-19 vaccine is required to fill out and file the multi dose consent2docx form.
To fill out the covid-19 multi dose consent2docx form, individuals must provide their personal information, consent to receiving multiple doses of the vaccine, and sign the form.
The purpose of the covid-19 multi dose consent2docx form is to ensure that individuals understand and consent to receiving multiple doses of the Covid-19 vaccine.
The covid-19 multi dose consent2docx form must include the individual's personal information, consent to receiving multiple doses of the vaccine, and signature.
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