Get the free Use Continuation Page page 2 if necessary Items 2 4 5 6 17 18 - hhs
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VEERS Vaccine Adverse Event Reporting System www.vaers.hhs.gov Items 2, 4, 5, 6, 17, 18 and 21 are ESSENTIAL and must be completed. Patient identity kept confidential. Use Continuation Page (page
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Use continuation page is a form used to provide additional information or to continue a response that cannot fit on the main form.
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Anyone who needs to provide additional information or expand on a response in a document may be required to file a use continuation page.
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