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Clinic Number: 20152016 FLU VACCINE CONSENT Clinic Location: MONA www.MVNA.org Clinic Date: PRINT IN INK ONLY REQUIRED INFORMATION FOR CLIENT RECEIVING VACCINE (Legal name×Last Name First Name MI
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How to fill out 2015-2016 flu vaccine consent

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How to fill out 2015-2016 flu vaccine consent:

01
Start by carefully reading the consent form provided by your healthcare provider or vaccination center.
02
Fill out your personal information accurately in the required fields. This may include your full name, date of birth, address, and contact details.
03
Make sure to review the questions and statements on the form thoroughly.
04
Provide your medical history and any relevant information about allergies or adverse reactions to vaccines.
05
If applicable, indicate whether or not you have received the flu vaccine in previous years.
06
Sign and date the form in the designated area to confirm your consent for the vaccination.
07
Return the completed and signed form to the healthcare provider or vaccination center.

Who needs 2015-2016 flu vaccine consent:

01
Generally, anyone who wishes to receive the 2015-2016 flu vaccine at a healthcare provider or vaccination center may need to provide consent.
02
Minors under a certain age, usually below 18 years old, may require the consent of a parent or legal guardian to receive the vaccine.
03
In some cases, individuals with certain medical conditions may need to consult with their healthcare provider or provide additional consent documentation.
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Flu vaccine consent clinic is a clinic where individuals provide their consent to receive the flu vaccine.
Healthcare providers and clinics are required to file flu vaccine consent clinic for individuals receiving the flu vaccine.
Flu vaccine consent clinic can be filled out by providing information about the individual receiving the flu vaccine, their consent, and relevant medical history.
The purpose of flu vaccine consent clinic is to ensure that individuals are informed about the flu vaccine and provide their consent for vaccination.
Information such as individual's name, date of birth, medical history, consent for flu vaccine, and any relevant allergies or contraindications must be reported on flu vaccine consent clinic.
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