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Vaccine Informed Consent

YOU MUST:

  • Answer all the questions and complete every section of the consent form.
  • Submit one form for each patient.

If any of the following questions are not clear, please ask your health care provider for assistance.

We ask that a parent or guardian accompany all minors to their vaccination.

TIME TO COMPLETE:

5-10 minutes.

TIME TO PROCESS:

15-20 minutes.

DOCUMENTS TO UPLOAD:

Please have your insurance card and Medicare Part B red, white, blue card (if Medicare recipient) ready to upload.