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The document is a Tdap Vaccination Declination form where a patient acknowledges the recommendation to receive the Tdap vaccine for protection against tetanus, diphtheria, and pertussis. It outlines the risks associated with these diseases and provides statistics on their prevalence before vaccination. The patient can decline the vaccination for medical or other reasons but is informed that they can change their mind at any time.

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What is Tdap on a medical form?

Diphtheria, Tetanus, and Pertussis Vaccine Information Statements. DTaP (English / Other Languages) Td (English / Other Languages)

Is the Tdap vaccine necessary?

Tdap (Tetanus, Diphtheria, Pertussis) Vaccine VIS. Vaccines Immunizations.

What does Tdap stand for?

90714 Tetanus and diphtheria toxoids (Td) adsorbed, preservative free, when administered to individuals 7 years or older, for intramuscular use 90715 Tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap), when administered to individuals 7 years or older, for intramuscular use 90716 Varicella virus vaccine

What is the medical code for Tdap?

Tetanus, Diphtheria, and Pertussis (Tdap) Vaccines There are two Tdap vaccines used in the United States: Adacel and Boostrix. The Food and Drug Administration (FDA) approved both Boostrix and Adacel for use during pregnancy.

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