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STUDENT INFLUENZA CONSENT FORM 20152016 Student Information (Print all information in ink) Patient/Student Name (First, Middle, Last) School Name Parent/Guardian if Patient/Student is less than 18
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How to fill out student influenza consent form

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01
Start by downloading the student influenza consent form from your school's website or obtaining a physical copy from the school office.
02
Fill out the top section of the form, which typically includes the student's name, date of birth, grade level, and contact information.
03
Read and understand the information provided on the form regarding the purpose and benefits of the influenza vaccine.
04
Consult with your child's healthcare provider to determine if getting the influenza vaccine is appropriate for your child based on their medical history and any existing allergies or conditions.
05
If you decide to give consent for your child to receive the influenza vaccine, check the appropriate box or provide your signature in the consent section of the form.
06
Make sure to provide any additional information requested, such as the date and signature of the parent or guardian giving consent.
07
Return the completed form to the designated school personnel, following any specific instructions provided on the form or by the school.
08
Remember to keep a copy of the filled-out form for your records.

Who needs student influenza consent form?

01
The student influenza consent form is typically required for all students within a school or educational institution, regardless of age or grade level.
02
The form serves as a way for schools to obtain consent from parents or guardians regarding their child's participation in receiving the influenza vaccine.
03
It ensures that the school has proper authorization to administer the vaccine and helps keep track of which students have received the vaccine for public health and safety purposes.
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The student influenza consent form is a document that allows parents or guardians to give permission for their child to receive an influenza vaccination at school.
Parents or guardians of students who wish to have their child receive an influenza vaccination at school are required to file the student influenza consent form.
Parents or guardians can fill out the student influenza consent form by providing their child's information, medical history, and signing the form to give permission for the vaccination.
The purpose of the student influenza consent form is to obtain permission from parents or guardians to administer the influenza vaccination to students at school.
The student influenza consent form typically includes the student's name, date of birth, medical history, parent or guardian contact information, and permission to receive the vaccination.
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