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The document is a Screening Questionnaire and Consent Form for patients receiving vaccinations at a clinic. It collects patient information, medical history, and consent for vaccination while ensuring compliance with legal requirements. The form includes questions about health conditions, allergies, previous vaccinations, and authorizations for sharing medical information.

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See more rite aid consent form versions

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Versions	Form popularity	Fillable & printable
2020	4.8 Satisfied (94 Votes)
2017	4.4 Satisfied (108 Votes)
2017	4.4 Satisfied (58 Votes)
2016	4 Satisfied (43 Votes)
2016	4.2 Satisfied (57 Votes)

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