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The MacDuff School 66 School Street Granby, MA 01033 Attn: School Nurse (413) 255-0011 (phone) (413) 467-1603 (fax) Email: nurse MacDuff.org ANNUAL INFLUENZA VACCINE CONSENT FORM Student Name Student

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How to fill out 2014-2015 annual influenza vaccine

How to fill out 2014-2015 annual influenza vaccine?

01

Visit your healthcare provider or local pharmacy: To fill out the 2014-2015 annual influenza vaccine, you first need to visit either your healthcare provider or a local pharmacy. They will have the necessary vaccine and equipment to administer it.

02

Complete the necessary paperwork: Before receiving the vaccine, you will be required to fill out some paperwork. This may include personal information, medical history, and any allergies you may have. Make sure to provide accurate and up-to-date information to ensure proper administration of the vaccine.

03

Consult with a healthcare professional: After completing the paperwork, you will have the opportunity to consult with a healthcare professional. They can answer any questions or address any concerns you may have regarding the influenza vaccine. They will also assess your eligibility for the vaccine and determine if any precautions need to be taken.

04

Receive the vaccine: Once everything is in order, the healthcare professional will administer the 2014-2015 annual influenza vaccine. They will use a needle to inject the vaccine into your body, typically in the upper arm.

05

Follow aftercare instructions: After receiving the vaccine, the healthcare professional will provide you with aftercare instructions. This may include information about potential side effects, what to do in case of an adverse reaction, and any additional precautions to take.

Who needs 2014-2015 annual influenza vaccine?

01

Everyone aged 6 months and older: According to the Centers for Disease Control and Prevention (CDC), everyone aged 6 months and older should receive the annual influenza vaccine. This includes children, adults, and elderly individuals.

02

Individuals at high risk: Certain individuals are at a higher risk of developing severe complications from influenza. This includes pregnant women, young children, people with chronic health conditions (such as asthma, diabetes, or heart disease), and the elderly. It is especially important for these individuals to receive the annual influenza vaccine to protect themselves and reduce the risk of serious illness.

03

Healthcare workers and caregivers: Healthcare workers and caregivers are often in close contact with individuals who may be infected with the influenza virus. To protect themselves and prevent transmission to vulnerable populations, it is recommended that healthcare workers and caregivers receive the annual influenza vaccine.

04

Individuals in close contact with high-risk groups: If you regularly come into close contact with individuals in high-risk groups, such as elderly family members or individuals with chronic illnesses, it is important to get vaccinated. This will help protect them from potential exposure to the influenza virus through you.

05

Individuals looking to prevent illness and reduce transmission: Even if you are not considered high risk or in close contact with vulnerable populations, getting the annual influenza vaccine can help prevent illness and reduce the transmission of the virus. By getting vaccinated, you contribute to the overall decrease in influenza cases within the community.

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What is annual influenza vaccine consent?

Annual influenza vaccine consent is a form that gives permission for an individual to receive the flu vaccine each year.

Who is required to file annual influenza vaccine consent?

Annual influenza vaccine consent must be filed by individuals who wish to receive the flu vaccine each year.

How to fill out annual influenza vaccine consent?

To fill out annual influenza vaccine consent, an individual must provide their personal information, medical history, and signature indicating their consent to receive the vaccine.

What is the purpose of annual influenza vaccine consent?

The purpose of annual influenza vaccine consent is to ensure that individuals are aware of and agree to receive the flu vaccine each year for preventative health measures.

What information must be reported on annual influenza vaccine consent?

Annual influenza vaccine consent may require information such as personal details, medical history, and consent signatures.

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