Vaccine Protocol Agreement Sample Contracts

Vaccine Protocol Agreement
Vaccine Protocol Agreement • October 24th, 2023

This Vaccine Protocol Agreement (the "Protocol") authorizes the Georgia licensed pharmacists (the "Pharmacists"), or nurses (“Nurses”) identified on the following pages of this Protocol to act as delegated agents for the undersigned physician (the "Physician").

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Vaccine Protocol Agreement for Pharmacist-Administered Vaccines
Vaccine Protocol Agreement • December 14th, 2021 • Georgia

practicing in the State of Georgia and not employed by Pharmacy, and Genoa Healthcare, LLC (Pharmacy), a Georgia licensed pharmacy, for the purpose of setting forth the terms under which a pharmacist (Pharmacist), who is employed by Pharmacy and has signed an affidavit (Attachment 1), may administer vaccines without a prescription.

GENERAL INFORMATION
Vaccine Protocol Agreement • September 14th, 2018

The Board has approved a vaccine protocol template that is available on the Board’s website at www.medicalboard.georgia.gov. Although the use of this template is not required, the Board recommends using the template to expedite the processing of the vaccine protocol agreement.

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