Loading
    • Reporter Information
    • Patient Information
    • Report an Adverse Event
    • Additional Information
    • 1 of 4
    • 25%
    • COVID-19 Reporting Form For Adverse Events Following Immunization (AEFI)

    • This form is to be completed by physicians for any patients who may have experienced an adverse event following immunization.

    • Reporter Information

    • / /
    • / /