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Vaccination Assessment and Consent: COVID-19 Vaccine Individuals should be given the EUA Fact Sheet for Recipients and Caregivers before vaccination | *Under the Food and Drug Administration (FDA)
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01
Read the pre-vaccination assessment -screening questionnaire carefully.
02
Fill in all the required information accurately.
03
Answer all the questions honestly and to the best of your knowledge.
04
If you are unsure about any question, consult with a healthcare provider before filling out the form.
05
Submit the completed questionnaire to the healthcare provider administering the vaccination.

Who needs pre-vaccination assessment -screening questionnaire?

01
Anyone who is scheduled to receive a vaccination.
02
Individuals with a history of allergic reactions to vaccines or vaccine components.
03
People with underlying health conditions that may interact with the vaccine.
04
Pregnant women or individuals who are immunocompromised.
05
Children or elderly individuals who may have specific contraindications to certain vaccines.
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Pre-vaccination assessment - screening questionnaire is a form that individuals need to fill out before getting vaccinated. It helps healthcare providers determine if it is safe for the individual to receive the vaccination.
Anyone who is planning to get vaccinated is required to fill out the pre-vaccination assessment - screening questionnaire.
The pre-vaccination assessment - screening questionnaire can usually be filled out online or in person at the healthcare provider's office. It typically asks for personal health information and any known allergies or medical conditions.
The purpose of the pre-vaccination assessment - screening questionnaire is to help healthcare providers assess the individual's health status and determine if there are any contraindications to receiving the vaccination.
The pre-vaccination assessment - screening questionnaire usually asks for personal information, medical history, allergies, current medications, and any previous adverse reactions to vaccines.
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