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Vaccine Informed Consent (COVID-19)MODERNAPatient Information First Name: ___ Last Name: ___Date of Birth: ___Street: ___Age: ___ *MUST BE OVER 12City: ___ Zip Code: ___Phone: ___ Circle one: Male
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How to fill out screening and informed consent

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Read the screening and informed consent forms thoroughly.
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Provide your name, contact information, and any other required personal details.
03
Answer any screening questions honestly and to the best of your knowledge.
04
Sign and date the informed consent form to indicate your agreement to participate in the study.

Who needs screening and informed consent?

01
Screening and informed consent are needed for individuals who are participating in research studies, clinical trials, or medical procedures where their participation and agreement are required.
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Screening involves identifying potential participants for a study based on specific criteria, while informed consent involves obtaining permission from participants after providing detailed information about the study.
Research studies involving human participants are required to file screening and informed consent.
Screening and informed consent forms are typically filled out by the researchers or research team conducting the study.
The purpose of screening and informed consent is to ensure that participants are fully informed about the study and voluntarily agree to participate.
Screening and informed consent forms must include details about the study objectives, risks, benefits, confidentiality, and participant rights.
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