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V A C C I N E A D M IN I S T R A T I ON C O N S E NT F OR M
images.heb.comV A C C I N E A D M IN I S T R A T I ON C O N S E NT F OR M ... (s) and have received, read and/or had explained to me the Vaccine Information Statements and/or Emergency Use Authorization Fact Sheets on the vaccine(s) I have elected to receive. I also acknowledge that I have had a chance to ask questions and that such questions were answered ...