• Home
  • COVID-19 Vaccine Informed Consent - Resident/Client – DIGITAL FORM

COVID-19 Vaccine Informed Consent - Resident/Client – DIGITAL FORM

(0) No Reviews yet
$110.00
SKU: 7125E
$110.00
Electronically Delivered eForm* - Available Now – Subscribe Today


Briggs Digital forms: 

-Updates included with annual subscription
-Form-fillable PDF documents at your fingertips
-Easy to complete on any device

 

This new form provides for informing the resident/client about COVID-19 illness and is used to document consent or declination of the COVID-19 vaccine. It includes information regarding:

         Brief discussion of how the coronavirus is spread   

         Clinical symptoms of COVID-19 illness

         Populations that should receive the COVID-19 vaccine

         Who should not receive or wait for the vaccine

         Clinical side effects of the vaccine

         2 currently available vaccines: Pfizer-BioNTech and Moderna with hyperlinks to obtain the current Fact Sheets for each as part of obtaining informed consent [no VIS available as these vaccines are provided via EUA (Emergency Use Authorization) at this time]

         Option to sign for consent of the specific vaccine to be given, by resident/client or their representative

         Option to decline the vaccine, by resident/client or their representative 

         Witness signature 

 

Download a Sample today!


License Agreement

Send completed License Agreements to CustomerSupport@BriggsCorp.com

*This this digital form is delivered as a form-fillable PDF and includes 1-year of updates.   To receive your electronic file and updates you must complete and return a content license agreement and provide an end-user email address and contact name for file delivery (please allow 2-3 business days for order fulfillment).  After 1- year, your update subscription will automatically renew.

Delivery:  Digital* 

DIGITAL/ELECTRONIC MERCHANDISE & SUBSCRIPTIONS: ALL DIGITAL AND ELECTRONIC PRODUCTS AND SUBSCRIPTIONS ARE NON-REFUNDABLE AND NON-RETURNABLE. 


*This this digital form is delivered as a form-fillable PDF and includes 1-year of updates.   To receive your electronic file and updates you must complete and return a content license agreement and provide an end-user email address and contact name for file delivery (please allow 2-3 business days for order fulfillment).  After 1- year, your update subscription will automatically renew.

Ratings & Reviews

No reviews available

Be the first to Write a Review