Covid Consent Form. (clinic, health department, pharmacy, etc.,)_____ address:_____city:_____county:_____ state:_____ zip code: Message & data rates may apply.
COVID19 Updates allengray
5 june 2023 date last updated: (clinic, health department, pharmacy, etc.,)_____ address:_____city:_____county:_____ state:_____ zip code: Message & data rates may apply. Text your zip code to 438829. If you're having problems using a document with your accessibility tools, please contact us for help. *ages 12 years and older *question #12 pertain to bivalent booster dose eligibility for those who have completed a primary series of pfizer, moderna, novavax or janssen or those who have received a previous monovalent booster. Since applicable medical consent laws are a matter of state, tribal, or territorial law, providers are advised to consult with their legal counsel to assure compliance with the scope of those consent laws. Web by my signature below, i consent to the administration of the vaccine(s) by a pharmacist or a supervised student pharmacist or technician, or other authorized person, where permitted by law or state/federal guidance, employed or contracted by albertsons companies or one of its affiliated pharmacies and to be contacted at the number provided Take precautions regardless of your vaccination status. Find a vaccine near you.
Find a vaccine near you. 5 june 2023 date last updated: Text your zip code to 438829. Since applicable medical consent laws are a matter of state, tribal, or territorial law, providers are advised to consult with their legal counsel to assure compliance with the scope of those consent laws. If you're having problems using a document with your accessibility tools, please contact us for help. Message & data rates may apply. Web by my signature below, i consent to the administration of the vaccine(s) by a pharmacist or a supervised student pharmacist or technician, or other authorized person, where permitted by law or state/federal guidance, employed or contracted by albertsons companies or one of its affiliated pharmacies and to be contacted at the number provided Below you will find the moderna vaccine screening and consent forms: (clinic, health department, pharmacy, etc.,)_____ address:_____city:_____county:_____ state:_____ zip code: These steps help prevent spreading the virus to others in your household and your community. *ages 12 years and older *question #12 pertain to bivalent booster dose eligibility for those who have completed a primary series of pfizer, moderna, novavax or janssen or those who have received a previous monovalent booster.
