Patient Vaccine Resources

Patient Forms and Vaccine Information

• VSafe Instruction Sheet
• COVID Vaccination Consent Form (Moderna and Pfizer ONLY)
  Needs to be completed prior to arrival for the 1st, 2nd, 3rd or booster dose vaccination appointment
• COVID Vaccination Minor Third Party Consent Form (Applicable ONLY to Pfizer Vaccine) 
  Needs to be completed prior to arrival for the 1st and 2nd dose vaccination appointment if the parent or guardian of a minor is having another adult consent to their child's COVID-19 vaccine on their behalf
  • COVID Vaccination Minor Guarantor Form (Applicable to minors presenting with parents)
    • COVID Vaccination Minor QA
• COVID Booster v. 3rd Dose Table
• COVID Vaccinations Outside the US
• COVID-19 Vaccination After Care
• Moderna COVID-19 FAQ
• Pfizer COVID-19 FAQ
• COVID-19 Side by Side Vaccine Comparison
• COVID-19 Vaccine Interim COVID-19 Immunization Schedule
• EUA Recipient Pfizer 12 years and Older
• EUA Recipient Pfizer 6 months to 4 years of age
• EUA Recipient Moderna 6 months to 5 years of age
• EUA Recipient Moderna 6 Years to 11 years of age
• Moderna Vaccine At-A-Glance View
• Pfizer Vaccine At-A-Glance View
• Vaccine Schedule At-A-Glance View

Spanish Versions:

• COVID Vaccination Consent Form (Spanish)
  Needs to be completed prior to arrival for the 1st and 2nd dose vaccination appointment
• COVID Vaccination Minor Third Party Consent Form (Spanish) (Applicable ONLY to Pfizer Vaccine) 
  Needs to be completed prior to arrival for the 1st and 2nd dose vaccination appointment if the parent or guardian of a minor is having another adult consent to their child's COVID-19 vaccine on their behalf
• COVID-19 Vaccination After Care (Spanish)
• Moderna COVID-19 FAQ (Spanish)
• Pfizer COVID-19 FAQ (Spanish)
• Janssen COVID-19 FAQ (Spanish)
• VSafe Instruction Sheet (Spanish)

Other Languages:

• COVID Vaccination Consent Form (Farsi)
  Needs to be completed prior to arrival for the 1st and 2nd dose vaccination appointment
  • COVID Vaccination Minor Third Party Consent Form (Farsi) (Applicable ONLY to Pfizer Vaccine) 
    Needs to be completed prior to arrival for the 1st and 2nd dose vaccination appointment if the parent or guardian of a minor is having another adult consent to their child's COVID-19 vaccine on their behalf
  • COVID-19 Vaccination After Care (Farsi)
• COVID Vaccination Consent Form (Simplified Chinese)
  Needs to be completed prior to arrival for the 1st and 2nd dose vaccination appointment
  • COVID Vaccination Minor Third Party Consent Form (Simplified Chinese) (Applicable ONLY to Pfizer Vaccine) 
    Needs to be completed prior to arrival for the 1st and 2nd dose vaccination appointment if the parent or guardian of a minor is having another adult consent to their child's COVID-19 vaccine on their behalf
  • COVID-19 Vaccination After Care (Simplified Chinese)
• COVID Vaccination Consent Form (Traditional Chinese)
  Needs to be completed prior to arrival for the 1st and 2nd dose vaccination appointment
  • COVID-19 Vaccination After Care (Traditional Chinese)
• COVID Vaccination Consent Form (Vietnamese)
  Needs to be completed prior to arrival for the 1st and 2nd dose vaccination appointment
  • COVID Vaccination Minor Third Party Consent Form (Vietnamese) (Applicable ONLY to Pfizer Vaccine)
    Needs to be completed prior to arrival for the 1st and 2nd dose vaccination appointment if the parent or guardian of a minor is having another adult consent to their child's COVID-19 vaccine on their behalf
  • COVID-19 Vaccination After Care (Vietnamese)
• Moderna COVID-19 FAQ (Chinese)
• Moderna COVID-19 FAQ (Vietnamese)
• Pfizer COVID-19 FAQ (Chinese Simplified)
• Pfizer COVID-19 FAQ (Chinese Traditional)
• Pfizer COVID-19 FAQ (Farsi)
• Pfizer COVID-19 FAQ (Vietnamese)
• Janssen COVID-19 FAQ (Chinese)
• Janssen COVID-19 FAQ (Farsi)
• Janssen COVID-19 FAQ (Vietnamese)
• VSafe Instruction Sheet (Chinese)
• VSafe Instruction Sheet (Korean)
• VSafe Instruction Sheet (Vietnamese)