I agree that: 1. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. Bureau of Infectious Disease and Laboratory Sciences, COVID-19 vaccinations for children and youth ages 5-17. hb``g``h01G|A , }i=S1g\$y!$Lj*`eA*23 ,``LZdw &a`2M!>c*IP3~ c?U -
Scroll down to access downloads and media. This fun 30-second video (in Spanish) reminds us that preteens and teens need shots. The Moderna COVID-19 Vaccine is authorized in individuals 6 months of age and older as a primary series. Pfizer contra el COVID-19 necesitan el consentimiento de sus padres o tutores para recibir la vacuna de Pfizer contra el COVID-19. (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. We hope that you find these translations useful. vacuna contra la COVID-19 de Pfizer o Moderna. Consent If you do modify the form, please ensure you remove the Australian Government and COVID-19 Vaccination branding. You will be subject to the destination website's privacy policy when you follow the link. 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. State of Georgia government websites and email systems use georgia.gov or ga.gov at the end of the address. CDC COVID-19 Communication Toolkit: For Migrants, Refugees, and Other Limited-English-Proficient Populations in various languages. hb```RB eap`W?V%YOJtq(H~@AV f13::x_2@,6&AQu.RLWXn3gcbre+Z%|fbgi)|/i EXDA"' 0 Both forms must be complete at time of vaccination. Reporting is encouraged for other clinically significant adverse events, even if it is not clear that a vaccine caused the adverse event. You will be subject to the destination website's privacy policy when you follow the link. Please limit your input to 500 characters. The recipients health condition or recommendations for vaccination may change from one visit to the next. Address if different from above . The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. Commonwealth of Australia | Department of Health and Aged Care, COVID-19 vaccination Consent form for COVID-19 vaccination as, Japanese encephalitis virus (JEV) health alert, COVID-19 vaccination Advice for COVID-19 vaccine providers, COVID-19 vaccination Resource pack for residential aged care, COVID-19 vaccination Provider resources. This product (for ages 12 years and older) is no longer being distributed. A lock icon ( endstream
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Call 1-800-GEORGIA to verify that a website is an official website of the State of Georgia. 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. The U.S. Food and Drug Administration (FDA) has authorized the emergency use of certain COVID-19 Vaccines to prevent COVID-19 in individuals 6 months through 17 years under an 47 6 thatphanom.techno@gmail.com 042-532028 , 042-532027 While the agency has attempted to obtain translations that are as faithful as possible to the English version, we recognize that the translated versions may not be as precise, clear, or complete as the English version. We aim to provide documents in an accessible format. <>/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
Further, I hereby give my consent to the Florida Department of Health (DOH) or its agents to administer the COVID-19 vaccine. English Description: This consent form is not mandatory. endstream The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. endobj Vaccine Information Statements (VISs) are information sheets produced by the CDC that explain both the benefits and risks of a vaccine to vaccine recipients. 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. We will use this information to improve this page. We take your privacy seriously. Please do not include personal or contact information.
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\|Z5/'ACTSUBV.lfXVAxN)qU7\m8+$kQ*QC5OwU 5[]9xen2&a'$0H0_At9HBd:'u )"dAza|DQL(-I. Occupational Health and Safety Surveillance, Pregnancy Risk Assessment Monitoring System (PRAMS), Office of Health Indicators for Planning (OHIP), of Religious Objection to Immunization Spanish, Rules and Regulations: FAQs about Changes, Department of Public Health Certificate of Immunization (3231), Audit Checks for Child Care Facilities and Schools, Requirements and Recommendations for University System of Georgia Students, Guide 3231INS, Standards for Issuing and Filing Certificates of Immunization, of Georgia Immunization Requirements for Child Care & School Attendance, 3258 (Immunization Guidelines for Child Care Facility Operators and School Personnel), there for your child during shots (English and Spanish), for Teens: Protect Their Future (Spanish), Vaccine For Preteen Teaching Sheet English/, To the Wise: Immunize For Good Adult Health, of Refrigerated/Frozen Pack Needs for Different Climates, Recommendations Applying to Spacing and Administration of Routinely Recommended Childhood Vaccines, for Child and Adolescent Immunization Practices, Administration: Administer I.M. 431 0 obj Las vacunas Moderna y Pfizer contra el COVID-19 tienen un riesgo muy raro de inflamacin del corazn (llamada miocarditis o pericarditis). Local, state, and federal government websites often end in .gov. Suggestions are presented as an open option list only when they are available. The site is secure. If you need assistance, please contact the Department of Public Health. You can review and change the way we collect information below. New and Improved (Pneumococcal Conjugate) Vaccine (Una vacuna nueva y mejorada) 1:20 minutes They help us to know which pages are the most and least popular and see how visitors move around the site. For further assistance with reporting to VAERS, call 1-800-822-7967. Vaccinating children Updated Smallpox/Monkeypox VIS Now Available, National Center for Immunization and Respiratory Diseases, U.S. Department of Health & Human Services. Novavax - Novavax COVID-19 Vaccine, Adjuvanted FDA webpage Consent I have read and understand the information on benefits and risks of COVID-19 vaccines. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. Cookies used to make website functionality more relevant to you. %%EOF
This consent form, in Spanish, must be completed before receiving a COVID-19 vaccination. If you would like a response please use the enquiries form . 454 0 obj Find information and resources for each of the availablePfizer-BioNTech COVID-19 Vaccines. 402 0 obj 187 0 obj
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These cookies may also be used for advertising purposes by these third parties. endobj 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. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. This webpage includes additional links to key webpages from CDC, FDA, and other . This consent form is not mandatory. While consent before vaccination is mandatory in Australia, written consent is not required. It is provided as an example for vaccination providers to obtain patient consent prior to COVID-19 vaccination. Before sharing sensitive or personal information, make sure youre on an official state website. Esto se ve ms comnmente en hombres menores de 30 aos despus de la segunda dosis. Section 3: Consent. Follow the COVID-19 vaccination schedule (below) based on age and medical condition. . Federal law requires that healthcare staff provide a VIS to a patient, parent, or legal representative before each dose of certain vaccines. Page 2 of 3 The vaccine may not protect everyone from COVID-19 disease. Food and Drug Administration. They help us to know which pages are the most and least popular and see how visitors move around the site. These cookies may also be used for advertising purposes by these third parties. An official website of the State of Georgia. 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. Fecha %PDF-1.6
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We are always looking for ways to improve our website. Individuals must complete a vaccine screening and consent form to confirm eligibility. to be available under an EUA for certain populations, including Pfizer-BioNTech COVID-19 vaccine for those individuals 6 months to 11 years old, and Moderna COVID-19 vaccine for individuals 6 months to 17 years old and for the administration of a third dose in the populations set forth in the consent section below. Saving Lives, Protecting People, COVID-19 EUA Recipient/Caregiver Fact Sheets. If you would like to continue helping us improve Mass.gov, join our user panel to test new features for the site. While most patients may speak English, they may better understand about vaccines and vaccine-preventable diseases when the information is written in Spanish. . La mayora de las personas que han tenido estas All information these cookies collect is aggregated and therefore anonymous. 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. This consent form, in Spanish, must be completed before receiving a COVID-19 vaccination. Podcasts Your patients can download vaccine-specific, Spanish-language CDC podcasts to their computer and portable music/video player. I understand that the Pfizer Vaccine will be given in two . If you are being inoculated by CVS, we've included that form below. Are they obsolete? hbbd```b``V D}IN0Y 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. Federal law requires that healthcare staff provide a VIS to a patient, parent, or legal representative before each dose of certain vaccines. Page 1 of 2 Pfizer-BioNTech COVID-19 Vaccine Effective Date: 1/04/2021 . An official website of the State of Georgia. English Espaol (Spanish) CDC COVID-19 Communication Toolkit: For Migrants, Refugees, and Other Limited-English-Proficient Populations in various languages Pfizer-BioNTech COVID-19. Cookies used to make website functionality more relevant to you. COVID-19; COVID-19 vaccines; Is there anything wrong with this page? 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. Immunize.org has organized links to all key printable (PDF) documents from CDC and FDA in the Checklist of Current Versions of U.S. COVID-19 Vaccination Guidance and Clinic Support Tools (abbreviated on this page as the "Checklist" ). \r\rCS321629E\rJanuary, 2023 <>stream
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You Find interesting on CDC.gov through third party social networking and other websites vaccines and vaccine-preventable Diseases the... Now available, National Center for Immunization and Respiratory Diseases, U.S. Department of health & Human Services las. Han tenido estas All information these cookies collect is aggregated and therefore anonymous 30 aos despus de la dosis... Need assistance, please ensure you remove the Australian government and COVID-19.. Now available, National Center for Immunization and Respiratory Diseases, U.S. Department of health... Be completed before receiving a COVID-19 vaccination Australia, written consent is not required Espaol ( Spanish CDC! ) is no longer being distributed as pfizer covid vaccine consent form spanish example for vaccination providers to obtain consent! La mayora de las personas que han tenido estas All information these cookies is... Representative before each dose of certain vaccines ms comnmente en hombres menores de 30 aos despus de segunda! By going to our privacy policy when you follow the link that preteens and teens need shots this. Test new features for the site the form, in Spanish before sharing sensitive information, sure... Podcasts to their computer pfizer covid vaccine consent form spanish portable music/video player vaccines and vaccine-preventable Diseases when the information on benefits and risks COVID-19. Segunda dosis when the information is written in Spanish, must be completed before receiving a vaccination. Form to confirm eligibility these third parties the Australian government and COVID-19 vaccination by CVS we! Always do so by going to our privacy policy page medical condition EUA Recipient/Caregiver Fact Sheets prior. Be used for advertising purposes by these third parties the most and popular. Can always do so by going to our privacy policy page webpages from CDC, FDA, and Limited-English-Proficient... Option list only when they are available as a primary series Communication:! In an accessible format novavax - novavax COVID-19 Vaccine is authorized in 6. More relevant to you to know which pages are the most and least popular see. Consent form to confirm eligibility Australian government and COVID-19 vaccination need to go and... The recipients health condition or recommendations for vaccination may change from one visit to the accuracy of a website! 1-800-Georgia to verify that a website is an official state website CDC ) can not attest the.