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Walmart and Sam\'s Club Vaccine Administration Record and Informed Consent Section A (please print clearly) First Name: Date of Birth: City:Last Name: Sex assigned at birth: Female Male Home Address:
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Download the covid19-walmart-questionnaire-consent-formpdf from the njgov website.
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Who needs covid19-walmart-questionnaire-consent-formpdf - njgov?

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Individuals who are visiting Walmart for shopping or other purposes.
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Employees of Walmart who need to comply with company policies regarding COVID-19 safety measures.
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covid19-walmart-questionnaire-consent-formpdf - njgov is a consent form related to COVID-19 issued by the New Jersey government.
All individuals visiting Walmart stores in New Jersey are required to fill out and submit the covid19-walmart-questionnaire-consent-formpdf.
To fill out the covid19-walmart-questionnaire-consent-formpdf, individuals need to provide their personal information, answer health-related questions, and provide consent for COVID-19 screening protocols at Walmart stores.
The purpose of the covid19-walmart-questionnaire-consent-formpdf is to ensure the safety and well-being of all individuals visiting Walmart stores by implementing necessary COVID-19 screening measures.
The covid19-walmart-questionnaire-consent-formpdf requires individuals to report their personal information, answer health-related questions, and provide consent for COVID-19 screening protocols at Walmart stores.
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