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COVID-19 VACCINE SCREENING AND CONSENT FORM Moderna COVID-19 Vaccine SECTION 1: INFORMATION ABOUT YOU (PLEASE PRINT)Last NameFirst Name Day MaleYearRaceAmerican Indian or Alaska Native Hawaiian or
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covid-19-vaccine-moderna-pm-enpdf is a document containing information about the Moderna COVID-19 vaccine in English.
Healthcare providers or organizations distributing the Moderna COVID-19 vaccine are required to file covid-19-vaccine-moderna-pm-enpdf.
To fill out covid-19-vaccine-moderna-pm-enpdf, healthcare providers need to input information about the vaccine, such as lot number, expiration date, and administration details.
The purpose of covid-19-vaccine-moderna-pm-enpdf is to track and monitor the distribution and administration of the Moderna COVID-19 vaccine.
Information such as the lot number, expiration date, doses administered, and adverse reactions must be reported on covid-19-vaccine-moderna-pm-enpdf.
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