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MHS and Military OneSource To Your Health

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DHA Form 236: Pediatric (5-11 years) COVID-19 Vaccine Screening and Immunization Documentation

Form/Template
11/12/2021

This form is used to determine if the COVID-19 vaccine can be administered to the pediatric patient

Recommended Content:

COVID-19 Vaccine Toolkit | COVID-19 Vaccine Efforts | Children's Health | Immunization Healthcare

DHA Form 207: COVID-19 Vaccine Screening and Immunization Document, v16

Form/Template
3/25/2021

The purpose of this form is to determine if the COVID-19 vaccine can be administered to the patient. (v16, October 2021)

Recommended Content:

MHS Toolkits and Branding Guidance | MHS Toolkits and Branding Guidance | Coronavirus | COVID-19 Vaccine Efforts | COVID-19 Vaccine Toolkit | COVID-19 Information for Military Treatment Facility Directors
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