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Childhood-adolescent-immunization-administration-record 2025

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The document is a Childhood/Adolescent Immunization Administration Record that captures essential information regarding the administration of vaccines to patients. It includes sections for patient details, consent statements for vaccine information and data sharing with health systems, and a comprehensive list of vaccines administered along with their respective dates, manufacturers, and lot numbers. The form also allows for recording previous immunizations and includes specific codes related to the Vaccines for Children (VFC) program.

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