This COVID-19 vaccine consent form is for the use of CPESN facilities to collect patient consent regarding the Moderna Vaccine by asking vaccine recipients their personal and contact information, vaccine screening questions, vaccine manufacturer information and vaccine details, with their consent to the detailed terms and conditions regarding the vaccination process.
This Consent Form is accessible through desktop, mobile device, tablet and is fully customizable that allows you to change, add or remove the fields, include more information, change the design, and more. The sensitive patient data is protected with HIPAA friendly features, 100% free SSL encryption.