Tetanus/Diphtheria/Pertussis (Tdap) Vaccine Informed Consent

Informed Consent form for the administration of the Tetanus/Diphtheria/Pertussis (Tdap) vaccine. This form provides the information needed by the patient, parent , or responsible party as part of the education required for informed consent, including:

•Three (3) very serious diseases - tetanus, diphtheria, and pertussis

•Clinical symptoms of each disease

•Populations that should receive the Tdap vaccine

•Who should not receive or wait for the Tdap vaccine

•Clinical side effects of the Tdap vaccine

•Online location of the CDC VIS (Vaccine Information Statement)

•Acceptance/Declination options

Download a sample today!