COVID-19 Vaccine Pre-screening Form
The COVID-19 Vaccine Pre-screening Form is used by medical practitioners and pharmacists to screen potential COVID-19 vaccine recipients to determine whether there is any reason the patient should not receive the COVID-19 vaccine. Once screened, the individuals may be sent for further evaluation if they do not meet the necessary conditions.
With Jotform’s easy-to-use Form Builder, you can customize this free COVID-19 Vaccine Pre-screening Form to make it your own! Simply move form fields around and add or remove sections. If you need to collect additional information at a later date, just update the template and save it as a Draft — then come back later to complete it. With Jotform's HIPAA friendly features, you can automate the process of collecting your patients’ health information and save it all straight with Jotform integrations like Google Drive, Dropbox, etc. Make the most of your free Pre-screening Form and start screening patients online for the COVID-19 vaccine today.
These templates are suggested forms only. Before using this or any form as a contract or other legal document, please consult with an attorney to make sure it meets the legal needs or your situation. Do not use this form to send a legal request to Jotform.
These templates are suggested forms only. Before using this or any form as a contract or other legal document, please consult with an attorney to make sure it meets the legal needs or your situation. Do not use this form to send a legal request to Jotform.
