Follow the steps to complete your consent form online

1. Click the ‘Get Form’ button to access the consent form and open it in your preferred online editing platform.
2. Enter your full name in the ‘Recipient Name’ field. Make sure to print clearly and include your date of birth (DOB) in the designated section.
3. Provide your legal gender and preferred name if applicable. Fill in your address details, including city, state, and zip code.
4. Indicate your marital status using the provided options, and supply your email address and phone number for further contact.
5. If the recipient is a minor or requires assistance, include the name of the parent, guardian, or surrogate, and provide their contact information.
6. Select your preferred language and fill out the ethnicity and race sections according to the keys provided.
7. Specify the clinic or office site where the vaccine will be administered.
8. Answer the screening questionnaire honestly by marking the appropriate boxes for each question about your health status and recent vaccinations.
9. Review the Emergency Use Authorization (EUA) information, ensuring you understand the context and implications of receiving the vaccine.
10. In the consent section, confirm you have received and understood the vaccination information by signing and dating the form.
11. Submit the completed form online. Depending on the platform, you may have options to save changes, download a copy for your records, print, or share it as needed.

Complete your Nys Covid Vaccine Consent Form online today to help protect yourself and others.