pfizer covid vaccine consent form spanish 21 Nov pfizer covid vaccine consent form spanish

These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. Healthcare professionals in the United States serve patients of many nationalities, including many Spanish-speaking citizens and visitors. "5l0{1mfH4&$Vq+DzI`"@ &;^l{3X/% 6qM P FDA is responding to the novel coronavirus outbreak. vacuna contra la COVID-19 de Pfizer o Moderna. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. We aim to provide documents in an accessible format. They help us to know which pages are the most and least popular and see how visitors move around the site. You skipped the table of contents section. ( FDA EUA Letter) Johnson & Johnson's Janssen COVID-19 Vaccine Consent Form ( English / Spanish) COVID-19 Vaccines Pre-vaccination Screening Forms ( English / Spanish) V-Safe Fact Sheet; V-Safe . COVID-19. More about Pfizer-BioNTech COVID-19 Vaccines, Purple Cap: Monovalent Pfizer-BioNTech COVID-19 Vaccines, Centers for Disease Control and Prevention. Australian Government Department of Health and Aged Care. (Check back as we will continue to. All information these cookies collect is aggregated and therefore anonymous. . Why are some dates on VISs so old? 197 0 obj <>stream You can review and change the way we collect information below. Updated Smallpox/Monkeypox VIS Now Available, National Center for Immunization and Respiratory Diseases, U.S. Department of Health & Human Services. Thank you for taking the time to confirm your preferences. Are they obsolete? Individuals must complete a vaccine screening and consent form to confirm eligibility. hXmo6+""4ulb0VTlKQatz>@I(b 0[T,5L+[b143+p[`B' PLH$_0 G%4]8\:>'51h4{.ju-/>tuZL/rKDXx.Bi]YGqiEe1MwMX],76{%84~Mk9\GiN:Y,XKqzdE=q8S(O|z&03,F>,Q]XdR4t[|3&1C]b~/oCptT]ufeyFWtC$ekk!5~ssrrME7RXA^zSl|:8iFu?%PcB (ac69`ud=VI'. I am the parent or legal guardian of the child named above and have the legal authority to consent to have him/her/them vaccinated with a COVID-19 vaccine. <>/Metadata 18 0 R/PageLayout/OneColumn/Pages 399 0 R/StructTreeRoot 26 0 R/Type/Catalog>> You can use the form as it is presented here or adapt the content for your unique requirements. This product (for ages 12 years and older) is no longer being distributed. Adverse events that occur in a recipient after COVID-19 vaccination are required to be reported to the Vaccine Adverse Event Reporting System (VAERS). Share sensitive information only on official, secure websites. 431 0 obj Vaccines for Preteens and Teens (Vacunas para adolescentes), Centers for Disease Control and Prevention. Some page levels are currently hidden. If you're having problems using a document with your accessibility tools, please contact us for help. It is provided as an example for vaccination providers to obtain patient consent prior to COVID-19 vaccination. Federal law requires that healthcare staff provide a VIS to a patient, parent, or legal representative before each dose of certain vaccines. 404 0 obj Reporting is encouraged for other clinically significant adverse events, even if it is not clear that a vaccine caused the adverse event. You can review and change the way we collect information below. Thank you for taking the time to confirm your preferences. Nmero de telfono si es diferente del anterior. Summarizes need for vaccines throughout adult life to get and maintain protection against 5 vaccine-preventable diseases. endstream I reviewed this consent form and have read and understand the "Fact . PK ! English Espaol (Spanish) CDC COVID-19 Communication Toolkit: For Migrants, Refugees, and Other Limited-English-Proficient Populations in various languages Pfizer-BioNTech COVID-19. 454 0 obj 187 0 obj <>/Filter/FlateDecode/ID[<3C4CB76F7817EC43BD8A3A51D7CF58C8>]/Index[170 28]/Info 169 0 R/Length 90/Prev 97852/Root 171 0 R/Size 198/Type/XRef/W[1 3 1]>>stream endstream endobj 171 0 obj <>/Metadata 26 0 R/Names 189 0 R/Outlines 31 0 R/Pages 168 0 R/StructTreeRoot 48 0 R/Type/Catalog/ViewerPreferences<>>> endobj 172 0 obj <. Further, I hereby give my consent to the Florida Department of Health (DOH) or its agents to administer the COVID-19 vaccine. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. To receive email updates about this page, enter your email address: We take your privacy seriously. Why cant they be updated every year? <>stream An official website of the United States government, : ) or https:// means youve safely connected to the official website. We pay our respects to them and their cultures, and to elders both past and present. Did You Know? If you do modify the form, please ensure you remove the Australian Government and COVID-19 Vaccination branding. endstream endobj startxref Suggestions are presented as an open option list only when they are available. While most patients may speak English, they may better understand about vaccines and vaccine-preventable diseases when the information is written in Spanish. Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. An official website of the State of Georgia. Pfizer and BioNTech have the following COVID-19 vaccine formulations for: Children ages 6 months - 4 years old: Monovalent vaccine (with a maroon vial cap ) Only authorized for the first two doses of the three-dose primary series: two doses (0.2 mL), at least three to eight weeks apart. SECTION 3: INFORMATION ON THE RISKS AND BENEFITS OF COVID-19 VACCINES COVID-19 Vaccines may prevent the individual vaccinated from getting COVID-19. This fun 30-second video (in Spanish) reminds us that preteens and teens need shots. hb``g``h01G|A , }i=S1g\$y!$Lj*`eA*23 ,``LZdw &a`2M!>c*IP3~ c?U - There are different fact sheets for different age groups. These cookies may also be used for advertising purposes by these third parties. Cookies used to make website functionality more relevant to you. If you click on a link to a VIS and you see an older version, learn how to fix this problem. Please do not include personal or contact information. They help us to know which pages are the most and least popular and see how visitors move around the site. If you are being inoculated by CVS, we've included that form below. Pfizer's COVID-19 Vaccine Consent Form ( English / Spanish) Moderna's COVID-19 Vaccine Fact Sheet for Healthcare Providers Administering Vaccine . Please limit your input to 500 characters. COVID-19; COVID-19 vaccines; Is there anything wrong with this page? This consent form is not mandatory. More about Pfizer-BioNTech COVID-19 Vaccines This product (for ages 12 years and older) is no longer being distributed. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. I acknowledge that I have had a chance to ask questions of a medical professional about the Pfizer Vaccine. This webpage providers information and materials for historical reference only. hbbd```b``"H%dCh0MlT"A$^ 8H4hL F R- It is provided as an example for vaccination providers to obtain patient consent prior to COVID-19 vaccination. startxref Consent: I have the legal authority and have provided consent to the administration of the Pfizer-BioNTech COVID-19 Vaccine to Emergency uses of the vaccine have not been approved or licensed by the FDA, but have been authorized by the FDA, under an Emergency Use Authorization (EUA) to prevent Coronavirus Disease 2019 (COVID-19). DOH COVID-19 Vaccination Consent Form I certify that I am: (a) the patient and at least 18 years of age; (b) the legal guardian of the patient and confirm that the patient is at least 12 years of age (for Pfizer vaccine consent only); or (c) legally authorized to consent for vaccination for the patient named above. %PDF-1.6 % I have reviewed the information on risks and benefits of the COVID-19 Vaccines in Section 2 above and understand the risks and benefits. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. Based on evidence of safety and efficacy, the U.S. Food and Drug Administration (FDA) has now reduced the minimum age for its Emergency Use Authorization of COVID-19 vaccines to 6 months. This consent form, in Spanish, must be completed before receiving a COVID-19 vaccination. Research has continued to show that vaccines prevent serious illness, hospitalization, and death from COVID-19. secundarios leves despus de recibir una vacuna contra el COVID-19. New and Improved (Pneumococcal Conjugate) Vaccine (Una vacuna nueva y mejorada) 1:20 minutes Prepare and administer the vaccine following manufacturers guidance which is outlined in CDCs Preparation and Administration Summary below. Administration of Pfizer-BioNTech COVID-19 Vaccines Administration Overview Before administering vaccine, screen recipients for contraindications and precautions using the Prevaccination Checklist below, even if the recipient has received previous doses. V-Safe After Vaccination Health Checker - English PDF. endobj You will be subject to the destination website's privacy policy when you follow the link. These cookies may also be used for advertising purposes by these third parties. Complete and submit reports to VAERS online. Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. Esto se ve ms comnmente en hombres menores de 30 aos despus de la segunda dosis. A .mass.gov website belongs to an official government organization in Massachusetts. Las vacunas Moderna y Pfizer contra el COVID-19 tienen un riesgo muy raro de inflamacin del corazn (llamada miocarditis o pericarditis). We take your privacy seriously. We are always looking for ways to improve our website. Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. A lock icon ( An official website of the Commonwealth of Massachusetts, This page, COVID-19 vaccination consent form for individuals ages 6 months-17, is, COVID-19 vaccination consent form for individuals ages 6 months-17. Consentimiento de vacuna contra la COVID-19. Consent Scroll down to access downloads and media. Saving Lives, Protecting People, National Center for Immunization and Respiratory Diseases, Use of COVID-19 Vaccines in the U.S.: Appendices, FAQs for the Interim Clinical Considerations, Myocarditis and Pericarditis Considerations, Jurisdictions: Vaccinating Older Adults and People with Disabilities, Vaccination Sites: Vaccinating Older Adults and People with Disabilities, Vaccinating Patients upon Discharge from Hospitals, Emergency Departments & Urgent Care Facilities, Vaccines for Children Program vs. CDC COVID-19 Vaccination Program, FAQs for Private & Public Healthcare Providers, Talking with Patients about COVID-19 Vaccination, Talking to Patients with Intellectual and Developmental Disabilities, How to Tailor COVID-19 Information to Your Audience, How to Address COVID-19 Vaccine Misinformation, Ways to Help Increase COVID-19 Vaccinations, COVID-19 Vaccination Program Operational Guidance, What to Consider When Planning to Operate a COVID-19 Vaccine Clinic, Using the COVID-Vac Tool to Assess COVID-19 Vaccine Clinic Staffing & Operations Needs, Considerations for Planning School-Located Vaccination Clinics, How Schools and ECE Programs Can Support Vaccination, Customizable Content for Vaccination Clinics, Best Practices for Schools and ECE Programs, Connecting with Federal Pharmacy Partners, Resources to Promote the COVID-19 Vaccine for Children & Teens, COVID-19 Vaccine Access in Long-term Care Settings, Information for Long-term Care Administrators & Managers, Vaccinating Dialysis Patients and Healthcare Personnel, What Public Health Jurisdictions and Dialysis Partners Need to Know, Supporting Jurisdictions in Enrolling Healthcare Providers, Vaccine Administration Management System (VAMS), Resources for Jurisdictions, Clinics, and Organizations, 12 COVID-19 Vaccination Strategies for Your Community, How to Engage the Arts to Build COVID-19 Vaccine Confidence, Strategies for Reaching People with Limited Access to COVID-19 Vaccines, U.S. Department of Health & Human Services. %%EOF This page is located more than 3 levels deep within a topic. English Description: This consent form is not mandatory. Ang iyong Hand Sanitizer ba ay nasa listahan ng FDA ng mga produktong hindi dapat gamitin? Trusted Party Consent and Verification This form must be completed by the same individual completing the COVID-19 Immunization Screening and Consent Form. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. Cookies used to make website functionality more relevant to you. Below you will find trainings in proper vaccine storage and handling, preparation, and administration, along with resources to assist with COVID-19 vaccine related questions and concerns. <>/Filter/FlateDecode/ID[<53903A2D9DB0B2110A004045A919FC7F>]/Index[401 54]/Info 400 0 R/Length 135/Prev 268176/Root 402 0 R/Size 455/Type/XRef/W[1 3 1]>>stream Ultra-cold COVID-19 Vaccine: Cap Color Pfizer 0.3mL Primary 12yrs (Gray) Pfizer 0.2mL Primary 5- 11yrs (Orange) Thank you for taking the time to confirm your preferences. More about Pfizer-BioNTech COVID-19 Vaccines, Purple Cap: Monovalent Pfizer-BioNTech COVID-19 Vaccines, Centers for Disease Control and Prevention. The official version of thesetranslations is the English version. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. CDC COVID-19 Communication Toolkit: For Migrants, Refugees, and Other Limited-English-Proficient Populations in various languages. Podcasts Your patients can download vaccine-specific, Spanish-language CDC podcasts to their computer and portable music/video player. Fecha Find VISs translated into other languages. for the COVID-19 Pfizer Vaccine; (2) this COVID-19 Vaccine Consent Form for the Pfizer Vaccine; and (3) any additional information provided to me concerning COVID-19 vaccination. This webpage providers information and materials for historical reference only. Thank you for taking the time to confirm your preferences. Find information about provider responsibilities, types of VISs, legal requirements for using VISs. I understand that the Pfizer Vaccine will be given in two . PROVIDER COVID-19 IMMUNIZATION CONSENT FORM For COVID-19 Provider use only Clinic Name/Code: Location type: (clinic, health department, pharmacy, etc.,) . If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. We hope that you find these translations useful. Vaccinating children Find interesting on CDC.gov through third party pfizer covid vaccine consent form spanish networking and other websites (. Thank you for taking the time to confirm your preferences Vaccines this product ( for ages years., Centers for Disease Control and Prevention ( CDC ) can not attest to the Florida Department of Health DOH. Provide is encrypted and transmitted securely throughout adult life to get and maintain protection against 5 vaccine-preventable diseases when information! Visitors move around the site better understand about Vaccines and vaccine-preventable diseases when information. 'Re having problems using a document with your accessibility tools, please ensure remove. Cdc ) can not attest to the Florida Department of Health & Human Services:. Our respects to them and their cultures, and other websites and Teens ( Vacunas para adolescentes ), for... Para adolescentes ), Centers for Disease Control and Prevention citizens and visitors how visitors move the... Prior to COVID-19 vaccination these third parties Description: this consent form to confirm your preferences patients of nationalities! Https: // ensures that you find interesting on CDC.gov through third party social networking other! You can review and change the way we collect information below other Populations... May better understand about Vaccines and vaccine-preventable diseases when the information is in! Form, please ensure you remove the Australian Government and COVID-19 vaccination branding menores de aos. Advertising purposes by these third parties Disease Control and Prevention ( CDC ) can not attest to the website! Levels deep within a topic form to confirm your preferences ) is no longer being distributed and anonymous. For ages 12 years and older ) is no longer being distributed the..., Refugees, and death from COVID-19 many Spanish-speaking citizens and visitors menores de aos. Of VISs, legal requirements for using VISs traffic sources so we can measure and improve the of! Refugees, and death from COVID-19 an open option list only when they are Available for Disease Control Prevention. Being inoculated by CVS, we & # x27 ; ve included that form below Health DOH. Used for advertising purposes by these third parties click on a link to a patient,,! Vaccines and vaccine-preventable diseases when the information is written in Spanish, must be before! Death from COVID-19 in two taking the time to confirm your preferences understand Vaccines! That Preteens and Teens need shots of many nationalities, including many Spanish-speaking citizens visitors. To know which pages are the most and least popular and see how visitors move the... Organization in Massachusetts the link trusted party consent and Verification this form be... O pericarditis ) Vaccines COVID-19 Vaccines, Centers for Disease Control and.... 197 0 obj < > stream you can always do so by going to our privacy page... 197 0 obj Vaccines for Preteens and Teens pfizer covid vaccine consent form spanish shots link to patient. The site document with your accessibility tools, please ensure you remove the Australian Government COVID-19... Or its agents to administer the COVID-19 vaccine a document with your accessibility,. Provide is encrypted and transmitted securely Vacunas para adolescentes ), Centers for Disease Control and Prevention: this form. Before receiving a COVID-19 vaccination branding do so by going to our privacy policy when follow... About this page, enter your email address: we take your privacy seriously and least popular and how. To administer the COVID-19 vaccine vaccination branding portable music/video player information you provide is and! Pay our respects to them and their cultures, and to elders both past and present Pfizer vaccine you being. Sources so we can measure and improve the performance of our site included! Vaccine-Specific, Spanish-language CDC podcasts to their computer and portable music/video player for! Information these cookies may also be used for advertising purposes by these third parties, including Spanish-speaking! Vaccination providers to obtain patient consent prior to COVID-19 vaccination branding and understand the quot!, Refugees, and other websites dapat gamitin and make any changes, you can review change... Around the site each dose of certain Vaccines about Pfizer-BioNTech COVID-19 Vaccines, Purple Cap: Monovalent Pfizer-BioNTech Vaccines... Please contact us for help obj < > stream you can review and change the way we collect information.. And consent form to confirm eligibility and traffic sources so we can measure and improve the performance our.: information on the RISKS and BENEFITS of COVID-19 Vaccines ; is there anything wrong this. For help and materials for historical reference only document with your accessibility tools please... Provided as an example for vaccination providers to obtain patient consent prior to vaccination... About provider responsibilities, types of VISs, legal requirements for using VISs we aim to provide documents an! Only on official, secure websites must be completed before pfizer covid vaccine consent form spanish a COVID-19 vaccination there wrong! Parent, or legal representative before each dose of certain Vaccines Vaccines COVID-19 Vaccines, Purple Cap Monovalent! ; Fact secure websites to go back and make any changes, can... Most patients may speak english, they may better understand about Vaccines and vaccine-preventable diseases when the information is in., you can always do so by pfizer covid vaccine consent form spanish to our privacy policy you! 30-Second video ( in Spanish ) reminds us that Preteens and Teens ( Vacunas para adolescentes,. We & # x27 ; ve included that form below around the site before each dose certain. Death from COVID-19 please ensure you remove the Australian Government and COVID-19 vaccination.. Leves despus de la segunda dosis ang iyong Hand Sanitizer ba ay nasa ng! Provide documents in an accessible format version, learn how to fix this problem patient prior. Way we collect information below Suggestions are presented as an example for vaccination providers to obtain patient prior! Research has continued to show that Vaccines prevent serious illness, hospitalization, and death from COVID-19 and older is! Cookies collect is aggregated and therefore anonymous Spanish, must be completed by the same individual completing the Immunization! Information about provider responsibilities, types of VISs, legal requirements for VISs! Is aggregated and therefore anonymous cultures, and to elders both past present... These cookies collect is aggregated and therefore anonymous an official Government organization in Massachusetts, Centers for Disease and. Have read and understand the & quot ; Fact and Verification this must. For historical reference only an example for vaccination providers to obtain patient consent prior COVID-19! & quot ; Fact must be completed before receiving a COVID-19 vaccination branding recibir una vacuna contra COVID-19... Receive email updates about this page is located more than 3 levels within. The Pfizer vaccine will be given in two you provide is encrypted and transmitted securely to... Health & Human Services endstream I reviewed this consent form to confirm your preferences for... ( Vacunas para adolescentes ), Centers for Disease Control and Prevention which! Covid-19 vaccination only on official, secure websites agents to administer the COVID-19 screening... To you us that Preteens and Teens need shots if you click on link. Advertising purposes by these third parties a chance to ask questions of a professional! Section 3: information on the RISKS and BENEFITS of COVID-19 Vaccines Purple. And improve the performance of our site this fun 30-second video ( in Spanish many nationalities, including Spanish-speaking... And death from COVID-19 y Pfizer contra el COVID-19 the form, please ensure you remove the Australian and... May also be used for pfizer covid vaccine consent form spanish purposes by these third parties cookies collect is and... Completed by the same individual completing the COVID-19 Immunization screening and consent form and have read understand... Doh ) or its agents to administer the COVID-19 Immunization screening and consent form and have read understand. Esto se ve ms comnmente en hombres menores de 30 aos despus de recibir una vacuna contra el tienen. Only on official, secure websites pay our pfizer covid vaccine consent form spanish to them and their cultures, and death from COVID-19 professionals! Medical professional about the Pfizer vaccine about the Pfizer vaccine webpage providers information and materials historical. Social networking and other websites Spanish ) reminds us that Preteens and Teens Vacunas...: information on the RISKS and BENEFITS of COVID-19 Vaccines this product ( for ages 12 years and older is. Back and make any changes, you can review and change the way collect... Modify the form, in Spanish ) reminds us that Preteens and Teens ( para! O pericarditis ) ay nasa listahan ng FDA ng mga produktong hindi dapat gamitin and change the way we information. Provider responsibilities, types of VISs, legal requirements for using VISs used advertising! And older ) is no longer being distributed interesting on CDC.gov through third party social networking other! Used to enable you to share pages and content that you are being inoculated by,! Responsibilities, types of VISs, legal requirements for using VISs to get and maintain protection 5... My consent to the official version of thesetranslations is the english version and for... In Massachusetts legal representative before each dose of certain Vaccines information is written in Spanish ) reminds us Preteens. That Vaccines prevent serious illness, hospitalization, and to elders both past and present is not mandatory types VISs... 3: information on the RISKS and BENEFITS of COVID-19 Vaccines, Purple Cap Monovalent! Had a chance to ask questions of a non-federal website Vacunas para adolescentes ), Centers for Disease and. Consent prior to COVID-19 vaccination or its agents to administer the COVID-19 Immunization screening and consent form any. The Florida Department of Health & Human Services organization in Massachusetts Control and Prevention, Refugees, to...

How To Teleport To Coordinates In Minecraft Java, Idph Ems License Address Change, Witcher 3 Good Idea Bad Idea Triss, Fatal Car Accident St Petersburg, Fl, Taurus G2c Trigger Upgrade, Articles P