DESCRIPTION:
This is a basic COVID-19 Vaccine Questionnaire printable PDF. Quickly get to the point with your vaccination questions. Includes 3 important questions along with name, date of birth, signature, and date.
Questions:
- Have you had COVID-19 in the past 30 days? Yes / No
- Have you received a covid-19 vaccination? Yes / No
- If you have received the vaccine, did you receive all doses that were required? Yes / No
This PDF cannot be edited, it is for printing only.
WHAT YOU GET:
• PDF COVID-19 Vaccine Questionnaire Form - 8.5 x 11"
SPECIFICATIONS:
• US Letter Size 8.5 x 11" (portrait)
• Black Content
• White Margins
Product Information & Policies
Payment & Security
Your payment information is processed securely. We do not store credit card details nor have access to your credit card information.