Get Tetanus Consent Form
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How to fill out the Tetanus Consent Form online
Filling out the Tetanus Consent Form online is an essential step to receive the Tetanus, Diphtheria, and Pertussis (Tdap) vaccine. This user-friendly guide provides clear instructions on how to navigate the form effectively, ensuring you provide all necessary information.
Follow the steps to complete the consent form online.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Begin by reading the introductory section, which outlines the purpose of the vaccine and potential side effects. It is important to understand the risks and benefits before proceeding.
- Complete the section titled 'Female Employees Only' if applicable. If you are female, confirm that you are not pregnant by signing in the designated space and adding the date.
- In the 'Acceptance of the Vaccination' section, read and acknowledge the information about the vaccine. Print your name, sign the document, and date it to confirm your consent.
- Fill in the details related to your vaccination, including the date of dose, lot number, expiration date, and site of administration by circling 'left upper arm' or 'right upper arm.'
- If you choose to refuse the vaccination, complete the 'Refusal of Vaccination' section. Print your name, sign, and provide the date. Additionally, a witness must sign and date the refusal.
- Once all applicable sections are completed, review the form for accuracy. Make any necessary changes.
- Finally, save changes, and you will have options to download, print, or share the completed form for your records.
Complete your Tetanus Consent Form online today for a streamlined vaccination process.
Related links form
CDC recommends that all preteens and teens get a Tdap vaccine, preferably at 11 or 12 years old. Adults need to get a tetanus booster shot, either Td or Tdap, every 10 years to stay protected. Tetanus vaccines are safe. Most people who get a tetanus vaccine do not have serious problems with it.
Fill Tetanus Consent Form
That I understand the benefits as well as risks to me from receiving this vaccination and I wish to receive the Tetanus, Diphtheria, Pertussis vaccination. I am an adult who can legally consent for the person named below to get the vaccine. Access the current Vaccine Information Statement (VIS) for Tetanus, Diphtheria, and Pertussis. No information is available for this page. Download the "Vaccine Consent Form" and bring it with you. Please be sure you are filling out the form for the same day you anticipate receiving the vaccine. Vaccination Information Record: (One booster with in last 10 years. Must be 7 years of age or older (patients 7-12 must have a prescription). This form has two sections. Information about immunisation; A consent form for you to fill out and return to school.
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