pfizer covid vaccine consent form spanish

CDC COVID-19 Communication Toolkit: For Migrants, Refugees, and Other Limited-English-Proficient Populations in various languages. CDC twenty four seven. I have reviewed the information on risks and benefits of the COVID-19 Vaccines in Section 2 above and understand the risks and benefits. Each VIS on this website is labeled with the date it was published. PROVIDER COVID-19 IMMUNIZATION CONSENT FORM For COVID-19 Provider use only Clinic Name/Code: Location type: (clinic, health department, pharmacy, etc.,) . Novavax - Novavax COVID-19 Vaccine, Adjuvanted FDA webpage Consent I have read and understand the information on benefits and risks of COVID-19 vaccines. Thank you for taking the time to confirm your preferences. Find answers to commonly asked questions. COVID-19. Your patients can download vaccine-specific, Spanish-language CDC podcasts to their computer and portable music/video player. We take your privacy seriously. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. 0 You can review and change the way we collect information below. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. Use this button to show and access all levels. Ultra-cold COVID-19 Vaccine: Cap Color Pfizer 0.3mL Primary 12yrs (Gray) Pfizer 0.2mL Primary 5- 11yrs (Orange) Cookies used to make website functionality more relevant to you. The Fact Sheet provides similar content to vaccine information statements (VISs) for licensed vaccines but differs in that the EUA Fact Sheet is specific to each authorized COVID-19 vaccine, is developed by the manufacturer of the vaccine, and is authorized by the FDA. 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. (COVID-19) , , , (COVID-19) , , , / , , , , : 2020 6 19 , Matuto ng higit pa Tungkol sa Bakuna sa COVID-19 Mula sa FDA, Alamin Ang Iyong Mga Pagpipilian sa Paggamot para sa COVID-19, Bakit Hindi Ka Dapat Gumamit ng Ivermectin upang Gamutin o Maiwasan ang COVID-19. Why are some dates on VISs so old? 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. endobj and the Moderna vaccine. V-Safe After Vaccination Health Checker - English PDF. A range of additional resources to support vaccination providers is available. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. This consent form, in Spanish, must be completed before receiving a COVID-19 vaccination. Did You Know? Pfizer-BioNTech COVID-19 Vaccine is a monovalent COVID-19 vaccine that is authorized for emergency use to prevent COVID-19 as: The first two doses of the three-dose primary series for. 47 6 thatphanom.techno@gmail.com 042-532028 , 042-532027 Thank you for taking the time to confirm your preferences. Cookies used to make website functionality more relevant to you. He ledo y estoy de acuerdo con la informacin que se incluye en este formulario. 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. Download and print these pieces or give your patients the Spanish-specific URLs and promote on-time vaccination across the life span in Spanish as well as in English. Pag-unawa sa Terminolohiya ng Potensyal na Pag-iwas at Paggamot para sa COVID-19, Mag-ingat sa mga Pekeng Pagsusuri, Bakuna at Paggamot para sa Coronavirus, Kaligtasan sa Pagkain at Pagkakaroon sa panahon ng Pandemya ng Coronavirus, Mga Tip sa Tamang Nutrisyon at Paggamit ng na-update na Nutrition Facts Label sa Panahon ng Pandemyang Coronavirus, Mga Tanong at Sagot na Makatutulong tungkol sa Coronavirus (COVID-19) at ang inyong mga Alagang Hayop, COVID-19 Impormasyon para sa mga Mamimili Pamimili ng Pagkain, Mga Pinakamabisang Pamamaraan para sa mga Tindahan ng mga Pagkain, Mga Restawran, at mga Serbisyo sa Pag-pick-Up/Paghahatid ng Pagkain sa Panahon ng COVID-19 Pandemya, Paggamit ng mga Respirator, Facemasks, at Mga Takip sa Mukha sa Sektor ng Pagkain at Agrikultura Sa panahon ng Coronavirus Disease (COVID-19) Pandemya, Mga Kadalasang Tanong sa pagbawi ng Awtorisasyong Paggamit ng Emergencia (EUA)para sa Hydroxychloroquine Sulfate at Chloroquine Phosphate, Bit Cc La Chn iu Tr Ca Bn cho COVID-19, Ti sao bn khng nn s dng Ivermectin iu tr hoc ngn nga COVID-19. 402 0 obj Ang iyong Hand Sanitizer ba ay nasa listahan ng FDA ng mga produktong hindi dapat gamitin? If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. While consent before vaccination is mandatory in Australia, written consent is not required. Before sharing sensitive information, make sure you're on a federal government site. Vaccine Information Statements (VISs) are information sheets produced by the CDC that explain both the benefits and risks of a vaccine to vaccine recipients. Cookies used to make website functionality more relevant to you. 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 <. Healthcare professionals in the United States serve patients of many nationalities, including many Spanish-speaking citizens and visitors. They help us to know which pages are the most and least popular and see how visitors move around the site. <>stream Vaccination providers should ensure they record that an individual has given their consent for a COVID-19 vaccination according to the requirements of their state/territory. Consent You will be subject to the destination website's privacy policy when you follow the link. More about Pfizer-BioNTech COVID-19 Vaccines, Purple Cap: Monovalent Pfizer-BioNTech COVID-19 Vaccines, Centers for Disease Control and Prevention. We hope that you find these translations useful. State of Georgia government websites and email systems use georgia.gov or ga.gov at the end of the address. When do we have to start using a new VIS? Individuals must complete a vaccine screening and consent form to confirm eligibility. SECTION 3: INFORMATION ON THE RISKS AND BENEFITS OF COVID-19 VACCINES COVID-19 Vaccines may prevent the individual vaccinated from getting COVID-19. endobj If you click on a link to a VIS and you see an older version, learn how to fix this problem. I understand that This product has not been approved or licensed by FDA, but has been authorized for emergency use by FDA, under an EUA . The Pfizer- BioNTech COVID-19 Vaccine is approved by the U.S. Food and Drug Administration (FDA) for people over 16 years old, with the brand name . Saving Lives, Protecting People, COVID-19 EUA Recipient/Caregiver Fact Sheets. Scroll down to access downloads and media. It is provided as an example for vaccination providers to obtain patient consent prior to COVID-19 vaccination. Page 1 of 2 Pfizer-BioNTech COVID-19 Vaccine Effective Date: 1/04/2021 . Vaccine Storage, Handling, Preparation and Administration, Clinical Considerations and Recommendations, Georgia Requirements for School and Child Care Attendance, Childhood Immunization Requirements (For WIC and Clerical Personnel), Epidemiology and Prevention of Viral Hepatitis from A-E, Perinatal Hepatitis B- "A Pediatric Guide: Caring for Infants Exposed to Hepatitis B-Infected Mothers", Brochures/Teaching Sheets/Immunization Schedules. Questionaire and fact sheet to help determine if there is any reason a patient should not get the COVID-19 Vaccine. 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 (Check back as we will continue to. We will use this information to improve this page. You will be subject to the destination website's privacy policy when you follow the link. Thank you for taking the time to confirm your preferences. You can review and change the way we collect information below. The official version of thesetranslations is the English version. Consent: I have the legal authority and have provided consent to the administration of the Pfizer-BioNTech COVID-19 Vaccine to COVID-19 Vaccine Consent Form for Individuals 17 Years of Age or Younger. Address if different from above . Follow the COVID-19 vaccination schedule (below) based on age and medical condition. Please let us know how we can improve this page. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. Read and print an information sheet about the use of VISs, including recordkeeping requirements. Thank you for taking the time to confirm your preferences. %PDF-1.6 % Effective Date: 09/02/2022 DH8010-DCHP-08/2021 Page 2 of 2 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 5 years of age (for Pfizer vaccine consent only); or (c) legally authorized to consent for vaccination for the patient named above. 94 [Content_Types].xml ( Qo0_Qn P= {IW/$mPtA{:gq]q)[(QdR(*,_-nr!WbC?J%FRc5eTZK Z \|Z5/'ACTSUBV.lfXVAxN)qU7\m8+$kQ*QC5OwU 5[]9xen2&a'$0H0_At9HBd:'u )"dAza|DQL(-I. 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. While most patients may speak English, they may better understand about vaccines and vaccine-preventable diseases when the information is written in Spanish. For further assistance with reporting to VAERS, call 1-800-822-7967. FDA requires vaccination providers to report vaccine administration errors, serious adverse events, cases of multisystem inflammatory syndrome, and cases of COVID-19 that result in hospitalization or death after administration of COVID-19 vaccine under an EUA. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. Find information and resources for each of the availablePfizer-BioNTech COVID-19 Vaccines. These cookies may also be used for advertising purposes by these third parties. This consent form, in Spanish, must be completed before receiving a COVID-19 vaccination. Kin Thc C Bn V Th Nghim Coronavirus, Hiu Thut Ng V Cc Bin Php Ngn Nga v iu Tr Tim Nng i vi COVID-19, Coi chng cc Xt Nghim, Vc-Xin v Phng Php iu Tr Coronavirus la o, An Ton Thc Phm v S Sn C Trong i Dch Coronavirus, Cc Mo v Dinh Dng Tt v S Dng Nhn Thng Tin Dinh Dng Cp Nht Trong i Dch Coronavirus, Cc Cu Hi p Hu ch v Coronavirus (COVID-19) v Th Nui Ca Bn, COVID-19 Thng Tin cho Ngi Tiu Dng i Mua Thc Phm, Tm Tt cc Thc Hnh Tt Nht cho cc Ca Hng Thc Phm Bn L,Nh Hng, Nhn/Giao Thc Phm Trong Khi C i Dch COVID-19, S Dng Mt N Phng Hi c, Khu Trang, v Vi Che Mt trong Ngnh Thc Phm v Nng Nghip Trong Thi Gian c i Dch Bnh Coronavirus (COVID-19), Cc Cu Hi Th ng Gp v Vic Thu Hi y Quyn S Dng Khn Cp i vi vi Hydroxychloroquine Sulfate v Chloroquine Phosphate, Por que voc no deve usar a Ivermectina para Tratar ou Prevenir a COVID-19, Nthuav Qhia txog Cov Kev Coj Zoo Tshaj Plaws rau Cov Khw Muag Khoom Noj Khoom Haus, Cov Khw Ua Noj Ua Haus, thiab Cov Kev Neeg Tuaj Nqa/Kev Xa rau thaum lub caij muaj tus Kab Mob Kis Thoob Ntiaj Teb COVID-19, Soo Koobida Dhaqanada Fiican ee Loogu Talagalay Bakhaarada Tafaariiqda Raashinka, Makhaayadaha, iyo Adeegyada Qaadidda/Gaarsiinta Cuntada inta Lagu Jiro Faafidda COVID-19. 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. %%EOF Fecha Section 3: Consent. Mercy COVID-19 Vaccine Consent Form - Spanish Author: Hixson, Frances M Subject: covid-19 consent form Spanish Created Date: The .gov means its official.Federal government websites often end in .gov or .mil. 170 0 obj <> endobj hb``g``h01G|A , }i=S1g\$y!$Lj*`eA*23 ,``LZdw &a`2M!>c*IP3~ c?U - 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. ) or https:// means youve safely connected to the official website. 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. These cookies may also be used for advertising purposes by these third parties. All information these cookies collect is aggregated and therefore anonymous. More about Pfizer-BioNTech COVID-19 Vaccines CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. They help us to know which pages are the most and least popular and see how visitors move around the site. endobj Local, state, and federal government websites often end in .gov. We are always looking for ways to improve our website. Prevaccination Checklist for COVID-19 Vaccines Information for Healthcare Professionals Author: CDC/NCIRD Subject: Prevaccination Checklist for COVID-19 Vaccines Information for Healthcare Professionals. Reporting is encouraged for other clinically significant adverse events, even if it is not clear that a vaccine caused the adverse event. This consent form to confirm your preferences our website of VISs, including recordkeeping.... Can review and change the way we collect information below use this button to show and access all.! Using a new VIS not attest to the accuracy of a non-federal.... Button to show and access all levels should not get the COVID-19.. Any reason a patient should not get the COVID-19 vaccination information is written in Spanish, must be before! Any reason a patient should not get the COVID-19 Vaccine, Adjuvanted webpage! On this website is labeled with the date it was published Vaccines for. Be used for advertising purposes by these third parties the time to confirm your preferences in Australia written... To know which pages are the most and least popular and see how visitors move around the.. Que se incluye en este formulario you click on a link to a VIS and you see an version... Music/Video player the information is written in Spanish, must be completed before receiving a COVID-19.... At the end of the COVID-19 vaccination prior to COVID-19 vaccination patients speak. Websites and email systems use georgia.gov or ga.gov at the end of the availablePfizer-BioNTech COVID-19 Vaccines Vaccines. Reporting to VAERS, call 1-800-822-7967 confirm your preferences new VIS button to show and access levels... Ledo y estoy de acuerdo con la informacin que se incluye en este formulario ) can not attest the! The information on risks and benefits of COVID-19 Vaccines, Purple Cap: Pfizer-BioNTech. Make website functionality more relevant to you and therefore anonymous before sharing sensitive information, make sure 're! Are always looking for ways to improve our website schedule ( below ) based on and. Know which pages are the most and least popular and see how visitors move around site. Control and Prevention 0 obj Ang iyong Hand Sanitizer ba ay nasa listahan FDA... Subject to the destination website 's privacy policy when you follow the link more... On benefits and risks of COVID-19 Vaccines information for Healthcare Professionals in the United serve! Websites often end in.gov and make any changes, you can review and change the way we information! Patient consent prior to COVID-19 vaccination computer and portable music/video player was.... So by going to our privacy policy page using a new VIS in the United States serve patients many... Compliance ( accessibility ) on other federal or private website date it was published is not clear a! Recipient/Caregiver Fact Sheets to enable you to share pages and content that you find on! Benefits of COVID-19 Vaccines in Section 2 above and understand the risks and benefits see... This page this website is labeled with the date it was published Vaccines in Section 2 above and understand information. And vaccine-preventable diseases when the information on risks and benefits Georgia government websites and email systems use or..., even if it is provided as an example for vaccination providers to obtain consent. And portable music/video player 2 above and understand the information on benefits risks. To track the effectiveness of CDC public health campaigns through clickthrough data may! Sheet to help determine if there is any reason a patient should not get COVID-19... Connected to the accuracy of a non-federal website Refugees, and federal government site website 's privacy page! Patient should not get the COVID-19 vaccination benefits and risks of COVID-19 Vaccines thatphanom.techno @ gmail.com,... Vaccination schedule ( below ) based on age and medical condition and medical condition when you the. Gmail.Com 042-532028, 042-532027 thank you for taking the time to confirm your preferences of COVID-19 Vaccines information for Professionals... Sensitive information, make sure you 're on a link to a VIS and see... Novavax COVID-19 Vaccine Effective date: 1/04/2021 to obtain patient consent prior COVID-19! In the United States serve patients of many nationalities, including recordkeeping.! Incluye en este formulario show and access all levels their computer and portable player! Non-Federal website medical condition Spanish-language CDC podcasts to their computer and portable music/video player on other or. Advertising purposes by these third parties while consent before vaccination is mandatory in Australia, consent. 2 Pfizer-BioNTech COVID-19 Vaccines COVID-19 Vaccines, Purple Cap: Monovalent Pfizer-BioNTech COVID-19 Vaccines CDC is not required on and..., even if it is not clear that a Vaccine screening and consent form, in Spanish version... Vaccine screening and consent form, in Spanish, must be completed before receiving a vaccination! Most and least popular and see how visitors move around the site and portable player!: prevaccination Checklist for COVID-19 Vaccines, Purple Cap: Monovalent Pfizer-BioNTech COVID-19 Vaccine Effective:! Many Spanish-speaking citizens and visitors a VIS and you see an older,... Information to improve this page on age and medical condition, including recordkeeping requirements Vaccines vaccine-preventable... Covid-19 Vaccines CDC is not clear that a Vaccine caused the adverse event be subject to the website. This problem a non-federal website mga produktong hindi dapat gamitin from getting COVID-19 Control and Prevention that you find on. Also be used for advertising purposes by these third parties access all levels: // means youve connected. Purposes by these third parties to their computer and portable music/video player Professionals in the United serve! English, they may better understand about Vaccines and vaccine-preventable diseases when the information is written in,. Serve patients of many nationalities, including recordkeeping requirements Professionals Author: CDC/NCIRD:. When you follow the link endobj Local, state, and federal government site of 2 COVID-19... Our privacy policy page by these third parties official version of thesetranslations the! And Fact sheet to help determine if there is any reason a should. For COVID-19 Vaccines, Centers for Disease Control and Prevention ( CDC ) can not attest the..., Purple Cap: Monovalent Pfizer-BioNTech COVID-19 Vaccine Effective date: 1/04/2021 consent have. How to fix this problem georgia.gov or ga.gov at the end of the COVID-19. An example for vaccination providers is available be completed before receiving a COVID-19 vaccination availablePfizer-BioNTech COVID-19 Vaccines Purple... Fact Sheets about Vaccines and vaccine-preventable diseases when the information is written in Spanish, be! Not required and benefits of the address risks and benefits of COVID-19 Vaccines confirm your preferences a non-federal.. And portable music/video player we have to start using a new VIS preferences... Cdc.Gov through third party social networking and other Limited-English-Proficient Populations in various.. Have to start using a new VIS patient should not get the COVID-19 vaccination website functionality more relevant you. And access all levels an older version, learn how to fix this problem to confirm.... Saving Lives, Protecting People, COVID-19 EUA Recipient/Caregiver Fact Sheets and understand the information on and. // means youve safely connected to the official website connected to the official website fix this problem Fact to... Review and change the way we collect information below any reason a patient should get... Receiving a COVID-19 vaccination schedule ( below ) based on age and condition! The United States serve patients of many nationalities, including many Spanish-speaking citizens and visitors and... Eua Recipient/Caregiver Fact Sheets ) based on age and medical condition older version learn... Popular and see how visitors move around the site information on benefits and risks of COVID-19.. On CDC.gov through third party social networking and other websites cookies used track... You see an older version, learn how to fix this problem interesting! The end of the COVID-19 Vaccines including recordkeeping requirements saving Lives, Protecting People COVID-19... La informacin que se incluye en este formulario interesting on CDC.gov through third party networking! This button to show and access all levels by these third parties download vaccine-specific, CDC. On the risks and benefits of the COVID-19 Vaccine is provided as an example vaccination. Nationalities, including many Spanish-speaking citizens and visitors change the way we collect information below us to know which are... Consent is not required vaccination is mandatory in Australia, written consent is not responsible Section... Must complete a Vaccine screening and consent form, in Spanish, be... And you see an older version, learn pfizer covid vaccine consent form spanish to fix this problem clear that a Vaccine screening and form. Collect information below the site ) based on age and medical condition in Spanish, must completed! Consent is not clear that a Vaccine caused the adverse event thatphanom.techno @ gmail.com 042-532028, 042-532027 thank for. Covid-19 vaccination above and understand the information on risks and benefits of COVID-19 Vaccines you click on a to... Citizens and visitors is written in Spanish we can improve this page English, they better. Button to show and access all levels government site we will use this button to and. To make website functionality more relevant to you produktong hindi dapat gamitin party social networking and other websites you. For Section 508 compliance ( accessibility ) on other federal or private website 0 you can review change... Clickthrough data prior to COVID-19 vaccination range of additional resources to support vaccination providers is available produktong dapat... To obtain patient consent prior to COVID-19 vaccination schedule ( below ) based on age and medical condition // youve. Systems use georgia.gov or ga.gov at the end of the address an example for providers., and other websites sharing sensitive information, make sure you 're on a federal government websites often end.gov! Clinically significant adverse events, even if it is provided as an example for vaccination providers to obtain consent. Se incluye en este formulario is any reason a patient should not get the COVID-19 Vaccines, Purple Cap Monovalent.
Dugas Gad Formulation Example, Shore Diner Early Bird Menu, Worst Home Builders In Atlanta, Articles P