Covid 19 Vaccine Phase 1b Screening Form
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COVID-19 Vaccine Phase 1B Screening Form
COVID-19 Vaccine Phase 1B Screening Form
Page 1
Personal Information
Description:Screen patients for eligibility for the COVID-19 vaccine Phase 1B with this screening form. Gather necessary information and assess patient risk factors.
Ensure a smooth and efficient COVID-19 vaccine distribution process with this screening form for Phase 1B. This form allows healthcare providers to gather important patient information and assess their eligibility for the vaccine based on risk factors. By using this form, healthcare providers can streamline the screening process and prioritize patients who are most in need of the vaccine. The form includes questions about age, occupation, underlying health conditions, and recent exposure to COVID-19. Use this form to help protect your patients and community during the pandemic.
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