The goal of this Family Financial Disclosure Form is to ensure that an adverse event or death of one family member does not translate into long-lived or permanent financial destruction for the entire family.
This form was created to assist families to communicate regarding and to prepare for the family-wide financial impact of adverse events, if any, resulting from a Covid-19 injection. Reported adverse events following Covid-19 injections include: death; anaphylaxis; blood clots and related complications; leaky blood vessels and related complications; heart problems (myocarditis and pericarditis); neurological disorders; autoimmune disorders; other chronic and inflammatory conditions; blindness and deafness; infertility; fetal damage; miscarriage and stillbirth; and Covid-19.
Traditionally, informed consent forms for vaccination do not provide disclosure or statistics related to financial costs of possible injury, disability, or death, nor do they discuss the impact on family time, resources, health, and wealth—impacts that may include reduced career potential, divorce, or effects on the education and future plans of other family members.
Consequently, it is essential that prior to receiving a Covid-19 injection, parents and family members with financial responsibility for children and spouses not only do thorough due diligence—providing adequate disclosures to their families regarding the potential costs to family members of adverse events or death—but also take steps to protect themselves and family members from the material adverse financial consequences of an adverse event or death.