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Vaccine Administration Record (VAR)—Informed Consent for ...

The following questions will help us determine your eligibility to be vaccinated today. All vaccines . 1. Do you feel sick today? ... read and/or had explained to me the EUA Fact Sheet on the vaccine(s) I have elected to receive. ... as well as for any requested items and services not covered by my insurance benefits. I understand that any ...

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  Eligibility, Fact, Sheet, Insurance, Fact sheet

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