Covid Vaccine Consent Form Template - (b) the legal guardian of the patient; Web i certify that i am: Or (c) a person authorized to. I certify that, as of the date of my vaccination, i am 18 or older and i meet one or more of the. I verify that i have been provided with and have. Web by my signature below, i consent to the administration of the vaccine(s) by a pharmacist or a supervised student. (a) the patient and at least 18 years of age;
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Web by my signature below, i consent to the administration of the vaccine(s) by a pharmacist or a supervised student. I verify that i have been provided with and have. Web i certify that i am: (a) the patient and at least 18 years of age; (b) the legal guardian of the patient;
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Web i certify that i am: Web by my signature below, i consent to the administration of the vaccine(s) by a pharmacist or a supervised student. I certify that, as of the date of my vaccination, i am 18 or older and i meet one or more of the. I verify that i have been provided with and have. (a).
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I certify that, as of the date of my vaccination, i am 18 or older and i meet one or more of the. (b) the legal guardian of the patient; (a) the patient and at least 18 years of age; Or (c) a person authorized to. Web i certify that i am:
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(a) the patient and at least 18 years of age; Web i certify that i am: (b) the legal guardian of the patient; I verify that i have been provided with and have. I certify that, as of the date of my vaccination, i am 18 or older and i meet one or more of the.
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Or (c) a person authorized to. I certify that, as of the date of my vaccination, i am 18 or older and i meet one or more of the. Web i certify that i am: (b) the legal guardian of the patient; Web by my signature below, i consent to the administration of the vaccine(s) by a pharmacist or a.
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(b) the legal guardian of the patient; I certify that, as of the date of my vaccination, i am 18 or older and i meet one or more of the. Or (c) a person authorized to. I verify that i have been provided with and have. Web i certify that i am:
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I verify that i have been provided with and have. Or (c) a person authorized to. Web i certify that i am: I certify that, as of the date of my vaccination, i am 18 or older and i meet one or more of the. (a) the patient and at least 18 years of age;
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I certify that, as of the date of my vaccination, i am 18 or older and i meet one or more of the. Web by my signature below, i consent to the administration of the vaccine(s) by a pharmacist or a supervised student. I verify that i have been provided with and have. (a) the patient and at least 18.
I certify that, as of the date of my vaccination, i am 18 or older and i meet one or more of the. (a) the patient and at least 18 years of age; (b) the legal guardian of the patient; Web i certify that i am: Web by my signature below, i consent to the administration of the vaccine(s) by a pharmacist or a supervised student. I verify that i have been provided with and have. Or (c) a person authorized to.
I Certify That, As Of The Date Of My Vaccination, I Am 18 Or Older And I Meet One Or More Of The.
I verify that i have been provided with and have. (a) the patient and at least 18 years of age; Web by my signature below, i consent to the administration of the vaccine(s) by a pharmacist or a supervised student. (b) the legal guardian of the patient;
Or (C) A Person Authorized To.
Web i certify that i am: